For many older women, urinary incontinence (UI) can be an embarrassing, inconvenient, and socially isolating medical condition. An NIA-funded study, published Sept. 4 in JAMA Internal Medicine, showed that a single, 2-hour group class in bladder health was modestly effective in reducing the frequency and severity of UI symptoms.
Most UI treatment guidelines call for behavioral interventions first, before medication or surgical treatments. In this year-long study, led by researchers at Beaumont Hospital and the University of Alabama at Birmingham, 463 women with UI ages 55 to 91 (46 percent African American) were randomly assigned either to a 2-hour bladder health class or to no treatment. Participants attended training at the outpatient clinics of three academic medical centers.
The class taught participants about bladder anatomy and function, types and causes of UI, bladder training, and behavioral strategies for bladder control. Participants also received materials to use at home, including a booklet, a CD, and an individualized toileting schedule.
Compared with the control group, the group that took the bladder health class showed statistically significant but clinically modest improvements on measures of UI severity, quality of life, and perceptions of improvement after 3, 6, 9, and 12 months. No significant improvement was found for pelvic floor muscle strength. The incremental cost per treatment success was less for the intervention group compared with the control group.
The researchers concluded that this noninvasive, cost-effective intervention can be implemented in nonmedical settings and offers a first-line approach that women can try before progressing to more intensive treatments.
This research was supported by NIH grant R01AG043383; NCT 02001714.
Reference: Diokno, AC, Newman, DK, Low, LK, et al. Group-administered behavioral treatment for urinary incontinence in older women: A multi-site randomized controlled trial. JAMA Internal Medicine. doi: 10.1001/jamainternmed.2018.3766. Published online Sept. 4, 2018.