1. Home>
2. Specialties>
3. Women's Health>
4. Summary and Comment

Urge Incontinence: Behavioral Treatment Works

Urge incontinence, which affects approximately 38% of elderly women, is often treated with antispasmodic drugs, but biofeedback techniques have also been shown to be effective. To compare the efficacy of these treatments, researchers randomized 197 female volunteers from a geriatric clinic who had urge or mixed incontinence to receive four sessions of biofeedback-assisted behavioral treatment, oxybutynin, or placebo during an eight-week period. The biofeedback sessions, run by trained nurse practitioners, involved teaching patients pelvic exercises and then using anorectal probes to help patients identify pelvic muscles.

Behavioral training resulted in an 80.7% reduction in recorded episodes of incontinence, as compared with drug treatment or placebo (68.5% and 39.4% reductions, respectively). The behavioral group reported the highest perception of improvement, with 74.1% stating they felt "much better," compared with 50.9% and 26.9% in the drug treatment and control groups, respectively.

Comment: This well-conducted trial suggests that behavioral modification with biofeedback might be a more effective treatment for urge incontinence than currently available drug treatments. Longer-term studies including a larger number of patients and longer follow-up are needed to determine whether the effects of behavior modification are lasting. An accompanying editorial points out that biofeedback may be expensive and that it is unclear whether it is superior to other individualized interventions. Primary care physicians should at least screen for this illness and teach patients pelvic exercises.

— SD Gharib

Published in Journal Watch Women's Health January 1, 1999

Citation(s):

Burgio KL et al. Behavioral vs. drug treatment for urge urinary incontinence in older women: A randomized controlled trial. JAMA 1998 Dec 16 280 1995-2000.

• Original article (Subscription may be required)
• Medline abstract (Free)

Resnick NM. Improving treatment of urinary incontinence. JAMA 1998 Dec 16 280 2034-2035.

• Original article (Subscription may be required)
• Medline abstract (Free)