Behavioral Training Doesn't Help Incontinence Outcomes

Adding behavioral intervention to drug therapy does not provide additional benefit to women

WEDNESDAY, July 28 (HealthDay News) -- Women who are on drug therapy for urge urinary incontinence do not improve their outcomes by adding behavioral intervention to their treatment program, according to a study in the August issue of The Journal of Urology.

Kathryn L. Burgio, Ph.D., of the University of Alabama at Birmingham, and colleagues randomized 64 women to treatment for urge urinary incontinence consisting of eight weeks (four visits) of drug therapy only (extended release oxybutynin) or drug therapy plus behavioral intervention, including pelvic floor muscle training and urge suppression techniques. The primary outcome was reduced frequency of incontinence episodes recorded in the women's bladder diaries at eight weeks (with follow-up at six and 12 months). Secondary outcomes were patient satisfaction, perception of improvement, and results on the Urogenital Distress Inventory and Incontinence Impact Questionnaire.

The researchers found that the frequency of incontinence decreased a mean of 88.5 percent in the drug-only group and by 78.3 percent in the group receiving combined drug therapy/behavioral intervention (P = 0.16). For those who completed the entire eight-week regimen, outcomes were not significantly different between the two groups. In addition, the groups did not differ significantly at six or 12 months' follow-up or for the secondary outcomes.

"When drug therapy is implemented with frequent individualized dose titration, daily bladder diaries and careful management of side effects, initiating concurrent behavioral training does not enhance outcomes for urge incontinence in women," the authors write.

Several authors disclosed financial relationships with pharmaceutical and/or medical device companies, including Ortho-McNeil and Aventis.

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