Behavioral vs Drug Treatment for Urge Urinary Incontinence in Older Women: A Randomized Controlled Trial

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 incontinen...

Full description

Saved in:
Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 1998-12, Vol.280 (23), p.1995-2000
Main Authors: Burgio, Kathryn L, Locher, Julie L, Goode, Patricia S, Hardin, J. Michael, McDowell, B. Joan, Dombrowski, Marianne, Candib, Dorothy
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Analysis of Variance
Behavior Therapy
Biofeedback, Psychology
Biological and medical sciences
Female
Humans
Mandelic Acids - therapeutic use
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Parasympatholytics - therapeutic use
Patient Satisfaction
Treatment Outcome
Urinary Incontinence - classification
Urinary Incontinence - drug therapy
Urinary Incontinence - therapy
Urinary system involvement in other diseases. Miscellaneous
Urinary tract. Prostate gland
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.280.23.1995