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Rehabilitation versus drug therapy for urge urinary incontinence: long-term outcomes

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Abstract

The objective of this study was to compare the residual effect of a 3-month rehabilitation treatment and a standard drug treatment for urge urinary incontinence (UUI) 21 months post intervention. Forty-four women (ages 27–68 years) who were diagnosed with overactive bladder (OAB) were divided into 2 treatment groups over 3 months: 24 women received rehabilitation (REH) and 20 women were treated with medication (MED) (oxybutynin ER). Outcomes measures included frequency of urination, quality of life (QoL), and number of side effects (no/SE), which were measured upon entry into the study (entry), completion of the intervention (3 months), and at follow-up 3 and 21 months after completion of treatment. In the follow-up period, there was a significant group–time interaction effect on freq/day and freq/night (p < 0.01). At the end of follow-up, the mean number of no/SE was significantly greater in the MED group compared to the REH group (3.3 ± 0.5 vs 2.4 ± 0.4; p < 0.05). A significant negative association was found between the urinary symptoms and the I-QoL at the 21-month follow-up (r p = −0.45 to−0.57, p < 0.05). In the long-term, the REH patients maintained and even improved the achievements of the intervention period while the MED patients deteriorated to baseline values in urinary frequency. The suggestion for future work is to investigate the effect of each REH treatment component on UUI symptoms.

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References

  1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) The standardization of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society (ICS). Am J Obstet Gynecol 187:116–126

    Article  PubMed  Google Scholar 

  2. Herbison P, Hay-Smith J, Ellis G, Moore K (2003) Effectiveness of anticholinergic drugs compared with placebo with the treatment of overactive bladder: systematic review. BMJ 302:841–844

    Article  Google Scholar 

  3. Berghmans LC, Hendriks HJ, De Bie RA, van Waalwijk van Doorn ES, Bo K, van Kerrebroeck PE (2000) Conservative treatment of urge urinary incontinence in women: a systematic review of randomized clinical trials. BJU Int 85:254–263

    Article  PubMed  CAS  Google Scholar 

  4. Messelink B, Benson T, Berghmans B, Bo K, Coros J, Fowler C, Laycock J, Lim P, van Lunsen RV, a Nijeholt GL, Pemberton J, Wang A, Watier A, van Kerrebroeck P (2005) Standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of International Continence Society. Neurourol Urodyn 24:374–380

    Article  PubMed  Google Scholar 

  5. Bo K, Berghmans LC (2000). Nonpharmacologic treatments for overactive bladder—pelvic floor exercises. Urology 55(5A Suppl):7–11

    Article  PubMed  CAS  Google Scholar 

  6. Wallace SA, Roe B, Williams K, Palmer M (2004) Bladder training for urinary incontinence in adults. Cochrane Database Syst Rev (1):CD001308

  7. Kafri R, Langer R, Dvir Z, Katz-Leurer M (2006) Rehabilitation vs drug therapy for urge urinary incontinence: short term outcome. Int Urogynecol J Pelvic Floor Dysfunct 18:407–411. DOI 10.1007/s00192-006-0163-1

    PubMed  Google Scholar 

  8. Patrick DL, Martin ML, Bushnell DM, Yalcin I, Wagner TH, Buesching DP (1999) Quality of life of women with urinary incontinence: further development of the incontinence quality of life instrument (I-QOL). Urology 53(1):71–76

    Article  PubMed  CAS  Google Scholar 

  9. Wang AC, Wang YY, Chen MC (2004) Single-blind, randomized trial of pelvic floor muscle training, biofeedback assisted pelvic floor muscle training, and electrical stimulation in the management of overactive bladder. Urology 63(1):61–66

    Article  PubMed  CAS  Google Scholar 

  10. Goldby LJ, Moore AP, Doust J, Trew ME (2006) A randomized controlled trial investigating the efficiency of musculoskeletal physiotherapy on chronic low back pain disorder. Spine 31:1083–1093

    Article  PubMed  Google Scholar 

  11. Miller J, Hoffman E (2006) The causes and consequences of overactive bladder. J Women’s Health 15(3):251–260

    Article  Google Scholar 

  12. Dmochowski RR (2006) The puzzle of OAB: controversies, inconsistencies, and insights. Int Urogynecol J Pelvic Floor Dysfunct 17:650–658. DOI 10.1007/s00192-005-0032-3

    Article  PubMed  Google Scholar 

  13. Garnett S, Abrams P (2003) The natural history of the overactive bladder and detrusor overactivity. A review of the evidence regarding the long term outcome of the overactive bladder. J Urol 169:843–848

    Article  PubMed  Google Scholar 

  14. Burgio KL, Locher JL, Goode PS, Hardin JM, McDowell BJ, Dombrowski M, Candib D (1998) Behavioral vs drug treatment for urge urinary incontinence in older women: a randomized controlled trail. JAMA 16 280(23):1995–2000

    Google Scholar 

  15. Millard RJ, Asia Pacific Tolterodine Study Group (2004) Clinical efficacy of tolterodine with and without a simplified pelvic floor exercise regimen. Neurourol Urodyn 23:48–53

    Article  PubMed  CAS  Google Scholar 

  16. Mattiasson JB, Hoye K, Wein AJ, Tolterodine Scandinavian Study Group (2003) Simplified bladder training augments the effectiveness of tolterodine in patients with an OAB. BJU Int 91(1):54–60

    Article  PubMed  CAS  Google Scholar 

  17. Teuissen TA, de Jonge A, van Weel C, Lagro-Janssen AL (2004) Treating urinary incontinence in elderly—conservative therapies that work: a systematic review. J Fam Pract 53(1):25–30

    Google Scholar 

  18. Toe JS, Briffa NK, Devine A, Dhaliwal SS, Prince RL (2006) Do sleep problems or urinary incontinence predict falls in elderly women? Aust J Physiother 52:19–24

    Google Scholar 

  19. Saarni SI, Harkanen T, Sintonen H, Suvisaari J, Koskinen S, Aromaa A, Lonnqvist J (2006) The impact of 29 chronic conditions on health related quality of life: a general population survey in Finland using 15D and EQ-5D. Qual Life Res 15:1403–1414. DOI 10.1007/s11136-006-0020-1

    Article  PubMed  Google Scholar 

  20. Oh SJ, Ku JH (2006) Impact of stress urinary incontinence and overactive bladder on micturition patterns and health-related quality of life. Int Urogynecol J Pelvic Floor Dysfunct 18:65–71. DOI 10.1007/s00192-006-0112-z

    Article  PubMed  Google Scholar 

  21. Bo K, Sherburn M (2005) Evaluation of female pelvic-floor muscle function and strength. Phys Ther 85:269–282

    PubMed  Google Scholar 

  22. Sapsford R (2004) Rehabilitation of pelvic floor muscles utilizing trunk stabilization. Man Ther 9:3–12

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Rehabilitation and Physical Therapy Centre, Maccabi Healthcare Services, Hasachlav 12, 75429, Rishon LeZion, Israel

    Rachel Kafri & Jeffrey Shames

  2. Shefela District, Maccabi Health Services, Rishon LeZion, Israel

    Meir Raz

  3. Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, 69978, Ramat Aviv, Israel

    Michal Katz-Leurer

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  1. Rachel Kafri
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  2. Jeffrey Shames
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  3. Meir Raz
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  4. Michal Katz-Leurer
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Correspondence to Rachel Kafri.

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Kafri, R., Shames, J., Raz, M. et al. Rehabilitation versus drug therapy for urge urinary incontinence: long-term outcomes. Int Urogynecol J 19, 47–52 (2008). https://doi.org/10.1007/s00192-007-0397-6

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  • DOI: https://doi.org/10.1007/s00192-007-0397-6

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