Behavioral Training With and Without Biofeedback in the Treatment of Urge Incontinence in Older Women

We investigated whether baseline characteristics were associated with treatment outcomes

Kathryn L. Burgio


Scholarcy highlights

  • Context Previous research on urge urinary incontinence has demonstrated that multicomponent behavioral training with biofeedback is safe and effective, yet it has not been established whether biofeedback is an essential component that heightens therapeutic efficacy
  • Interventions Patients were randomly assigned to receive 8 weeks of biofeedback-assisted behavioral training, 8 weeks of behavioral training without biofeedback, or 8 weeks of self-administered behavioral treatment using a self-help booklet
  • Intention-to-treat analysis showed that behavioral training with biofeedback yielded a mean 63.1% reduction in incontinence, verbal feedback a mean 69.4% reduction, and the self-help booklet a mean 58.6% reduction
  • Biofeedback to teach pelvic floor muscle control, verbal feedback based on vaginal palpation, and a self-help booklet in a first-line behavioral training program all achieved comparable improvements in urge incontinence in communitydwelling older women
  • Patients were randomized to behavioral treatment with biofeedback, behavioral treatment without biofeedback, or a control condition consisting of self-administered behavioral training
  • Patients who had not achieved at least 50% improvement underwent combined bladder-sphincter biofeedback to teach them to contract pelvic floor muscles against increasing volumes of fluid, in the presence of increasing urgency, and during detrusor contraction
  • Verbal feedback based on vaginal palpation was used in the first treatment session to help patients identify and contract pelvic floor muscles
  • Patients’ perceptions of treatment were significantly better for the 2 behavioral training interventions

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