In recent years the AUA has drastically expanded its advocacy efforts to support and promote bladder health. The AUA initiated the Bladder Health Alliance in 2014 to create a collaborative network of patient advocacy organizations, physicians and urological researchers in hopes of promoting bladder health awareness and remove associated stigmas. They even created Bladder Health Awareness Month, which is in November, to help increase public health educational opportunities. Currently they are advocating for prescription coverage for bladder medications, increasing research support for bladder health and working to support the continued use of telemedicine.

This fall, the Bladder Health Alliance was focused on women’s bladder health. A variety of topics were covered but advocacy for women’s health, research funding and prescription support were the main themes of the discussion panels. Dr. Rachel Rubin, urologist and sexual medicine specialist in Washington, DC, discussed the importance of the genitourinary syndrome of menopause and the effects of hormone withdrawal on bladder health. Overwhelming data show that local vaginal estrogen will prevent recurrent urinary tract infections (UTIs) in perimenopausal and postmenopausal women and is recommended in the AUA guidelines on recurrent UTI. Not only will vaginal estrogen decrease recurrent UTIs, but it will also improve many lower urinary tract symptoms, including frequency, urgency and dysuria. It will also help improve arousal and lubrication, and decrease painful penetration. The problem is that less than 7% of women with genitourinary syndrome of menopause are prescribed vaginal estrogen, and many who get the prescription don’t use it properly, can’t afford it, stop using it, or fear using it because of misinformation around theoretical harm and inappropriate boxed warnings based on data for systemic synthetic estradiol. This is just one example of the many bladder health concerns that deserve more national attention. We need to increase our advocacy efforts to help educate patients and providers, and advocate for legislation making these therapies more affordable for women.

To further support this and many other advocacy endeavors, the Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction (SUFU) has also enhanced their health policy initiatives. SUFU started a Health Policy Scholar program this year in combination with the AUA to allow urologists the opportunity to take time away from practice to learn some of the intricacies of health policy. During this year the Scholar will attend the advocacy roundtables at the AUA, the Bladder Health Alliance, AUA Health Policy weekend, meetings such as the RUC (American Medical Association [AMA]/Specialty Society Resource-Based Relative Value Scale Update Committee), CPT® or AMA House of Delegates meeting and the AUA Advocacy Summit. SUFU members have shown an increasing presence in recent years at the AUA Advocacy Summit, working with their national representatives to improve support from Congress for bladder health initiatives, and this is a great introduction for this.

Additionally, the AUA Urology Care Foundation works to support the improvement of urological care by funding research, developing patient education and advancing humanitarian initiatives. As part of this, the Bladder Health Committee, part of the larger Public Education Council, works to increase knowledge and awareness of bladder health conditions. The Bladder Health Committee has been quite productive over the past several years working to enhance public education materials on a variety of urological conditions, including bladder cancer, overactive bladder, recurrent UTIs, pelvic floor disorders etc. These handouts are available online at www.urologyhealth.org and are a fantastic resource for patients. There are currently 100 bladder health patient education materials translated into 8 languages and almost 200 total bladder health materials on the website for patient and provider use. These are reviewed frequently to ensure they include recommendations from the most up-to-date AUA guidelines as well.

While these committees and initiatives have been developed in recent years, we have much more to do to increase awareness of bladder health. There are many organizations that can use your help. Please get involved: Bladders Matter.