EAUN18: New perspectives in chronic bladder problems – Part 1

The 19th International Meeting of the European Association of Urology Nurses (EAUN18) held in Copenhagen last March attracted around 342 delegates from over 30 countries. With the participation of 45 faculty members together with the EAUN Board and EAUN Scientific Committee (chaired by Corinne Tillier), EAUN18 presented a comprehensive programme with 29 sessions and four courses.

Two European School of Urology (ESU) courses and two plenary sessions not only drew a high number of attendance but were also marked with enthusiastic discussions. Networking and updates on membership advantages took place at the EAUN Booth and the social activities included the Nurses’ Dinner, held at Nørrebro Byghus, activities which reflected the dynamic collaboration among European urological nurses.

It was a pleasure to be part of Europe’s biggest urological nursing event as a member of the Special Interest Group (SIG) during the EAUN18 in Copenhagen. As an SIG committee member, we collaborated with our colleagues with the goal to deliver optimal patient care.

The SIG organised a one-hour session format with three (15-minute) talks followed by a discussion which was very well received. Thanks to Jeannette Verkerk-Geelhoed, who chaired the session despite a short notice after the chairperson cancelled due to health reasons.

The session took up the management of chronic bladder problem with Sharon Holroyd discussing the misunderstanding on Urinary Tract Infections, Painful Bladder Syndrome (PBS), Interstitial Cystitis (IC), and Bladder Pain Syndrome (BPS). Veronique Phé (FR) shared her views on diagnosing and treating underactive bladder, while speaker Eva Wallace discussed the differential diagnosis for PBS/IC. PBS/ IC / PBS is a clinical diagnosis based on symptoms of urgency, frequency, and pain in the bladder and/or pelvis. “The complaint of supra-pubic pain related to bladder filling and accompanied by other symptoms such as increased daytime and night-time frequency in the absence of urinary infection or other obvious pathology,” according to ICS 2002.

PBS is a very debilitating, chronic condition that is difficult to diagnose (Davis et al, 2015). It was first diagnosed in the 19th century by S.D. Gross in 1876. Two years later in 1878 Skene identified it as chronic inflammatory lesion of the bladder wall. In 1915 G.L Hunner, using eight case histories identified urge, frequency, nocturia, suprapubic pain, visible lesions / ulcers on bladder wall. This is now known as Hunners Ulcers, a rare condition with only 10-15% of cases actually showing ulcers (Gupta et al, 2015). In the UK, there are approximately 400,000 people with this condition (Nickel et al, 2010).

This complaint is seen predominantly in female patients (Cashley et al, 2012), and some clinicians doubt the validity or existence of the condition (Warren 2014). However, there can be a lack of consensus on the terminology (Ghosh & Imoh-Ita 2014). Further discussion continues around diagnosing PBS/IC, which is most often made when long-standing urinary frequency, urgency, and pelvic pain exist in the absence of a readily identifiable sign, such as urinary tract infection. This was further discussed using some case studies.

Eva Wallace, RN, National Rehabilitation Hospital, Dept. of Urology, Dunlaoighre Co Dublin (IE),