Behavioral vs drug treatment for urge urinary incontinence in older women: a randomized controlled trial
Kathryn L. Burgio,Julie L. Locher,Patricia S. Goode,J M Hardin,B J McDowell,M. Dombrowski,D. Candib +6 more
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TLDR
Behavioral treatment is a safe and effective conservative intervention that should be made more readily available to patients as a first-line treatment for urge and mixed incontinence.Abstract:
Context.—Urinary incontinence is a common condition
caused by many factors with several treatment options.Objective.—To compare the effectiveness of
biofeedback-assisted behavioral treatment with drug treatment and a
placebo control condition for the treatment of urge and mixed urinary
incontinence in older community-dwelling women.Design.—Randomized placebo-controlled trial conducted from
1989 to 1995.Setting.—University-based outpatient geriatric medicine
clinic.Patients.—A volunteer sample of 197 women aged 55 to 92
years with urge urinary incontinence or mixed incontinence with urge as
the predominant pattern. Subjects had to have urodynamic evidence of
bladder dysfunction, be ambulatory, and not have dementia.Intervention.—Subjects were randomized to 4 sessions (8
weeks) of biofeedback-assisted behavioral treatment, drug treatment
(with oxybutynin chloride, possible range of doses, 2.5 mg daily to 5.0
mg 3 times daily), or a placebo control condition.Main Outcome Measures.—Reduction in the frequency of
incontinent episodes as determined by bladder diaries, and patients'
perceptions of improvement and their comfort and satisfaction with
treatment.Results.—For all 3 treatment groups, reduction of
incontinence was most pronounced early in treatment and progressed more
gradually thereafter. Behavioral treatment, which yielded a mean 80.7%
reduction of incontinence episodes, was significantly more effective
than drug treatment (mean 68.5% reduction;
P=.04) and both were more effective than the
placebo control condition (mean 39.4% reduction; P<.001 and
P=.009, respectively). Patient-perceived
improvement was greatest for behavioral treatment (74.1% "much
better" vs 50.9% and 26.9% for drug treatment and placebo,
respectively). Only 14.0% of patients receiving behavioral treatment
wanted to change to another treatment vs 75.5% in each of the other
groups.Conclusion.—Behavioral treatment is a safe and effective
conservative intervention that should be made more readily available to
patients as a first-line treatment for urge and mixed
incontinence.read more
Citations
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Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women
TL;DR: Overall, the review provides some support for the widespread recommendation that PFMT be included in first-line conservative management programmes for women with stress, urge, or mixed, urinary incontinence.
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Patient compliance with paper and electronic diaries
TL;DR: The findings call into question the use of paper diaries and suggest that electronic diaries with compliance-enhancing features are a more effective way of collecting diary information.
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Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline
E. Ann Gormley,Deborah J. Lightner,Kathryn L. Burgio,Toby C. Chai,J. Quentin Clemens,Daniel J. Culkin,Anurag K. Das,Harris E. Foster,Harriette Miles Scarpero,Christopher Tessier,Sandip Prasan Vasavada +10 more
TL;DR: This guideline provides a clinical framework for the diagnosis and treatment of non-neurogenic overactive bladder and identifies first through third line treatments as well as non-FDA approved, rarely applicable and treatments that should not be offered.
Journal ArticleDOI
Urinary Incontinence: Does it Increase Risk for Falls and Fractures?
Jeanette S. Brown,Eric Vittinghoff,Jean F. Wyman,Katie L. Stone,Michael C. Nevitt,Kristine E. Ensrud,Deborah Grady +6 more
TL;DR: To determine if urge urinary incontinence is associated with risk of falls and non‐spine fractures in older women, a large number of studies have found that it is not.
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Mind-Body Medicine: State of the Science, Implications for Practice
TL;DR: There is now considerable evidence that an array of mind-body therapies can be used as effective adjuncts to conventional medical treatment for a number of common clinical conditions.
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Marshal F. Folstein,Marshal F. Folstein,Susan E B Folstein,Susan E B Folstein,Paul R. McHugh,Paul R. McHugh +5 more
TL;DR: A simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
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Ananias C. Diokno,Ananias C. Diokno,Bruce M. Brock,Bruce M. Brock,Morton B. Brown,Morton B. Brown,A. Regula Herzog,A. Regula Herzog +7 more
TL;DR: The frequency of voiding was significantly increased among respondents with incontinence, or emptying or irritative symptoms compared to asymptomatic respondents, and these survey data are of importance to senior citizens, care providers and governmental agencies.