(Integrative Medicine) - Behavioral management including biofeedback may cut the severity of urinary incontinence (UI) in older women by more than half, according to a study funded by the National Institutes of Health. More than 13 million people in the United States are affected by UI, a commonly underreported condition characterized by loss of bladder control, and women are twice as likely as men to be affected.

Researchers randomly assigned 218 older women living in rural areas with UI to a home-based behavioral management group or to a control group. The behavioral intervention (with initial instruction from a nurse) involved 2 to 4 weeks of self-monitoring (such as reducing caffeine consumption), 6 to 8 weeks of bladder training, and 12 weeks of pelvic muscle exercise with biofeedback. The researchers observed the women for up to two years.

Urine loss decreased significantly in the behavioral intervention group compared to the control group. Over 2 years of follow-up, UI severity decreased by 61% in the behavioral intervention group and worsened by 184% in the control group.

"The worsening of UI severity in the control group merits consideration in light of the low rates of reporting UI or seeking care for UI by rural and other populations," the researchers note. "The improvement in the [behavioral intervention] group affirms the value of behavioral techniques as an approach that has high efficacy in the hands of community-based nurses."

References

Dougherty MC, Dwyer JW, Pendergast JF, et al. A randomized trial of behavioral management for continence with older rural women. Research in Nursing and Health. 2002;25:3-13.