Results of a randomized controlled clinical trial provide a rationale for urologists to integrate behavioral treatments into their practice for managing men with lower urinary tract symptoms (LUTS) of overactive bladder (OAB), according to the study’s authors.
The findings were published in JAMA Internal Medicine (Jan. 13, 2020 [Epub ahead of print]). The study, which had a two-stage, three-arm design, assigned men to 6 weeks of behavioral therapy alone, drug therapy alone, or combined therapy. In the second stage, a combined approach was used in all groups.
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Change in 24-hour voiding frequency documented in bladder diaries was assessed as the primary outcome, and it decreased significantly from baseline in all three groups. Combined therapy had the best results overall (–3.6, 30.5% change), and its benefit was significantly greater compared with drug therapy alone (–1.5, 12.7%) but not compared with behavioral therapy by itself (–2.9, 24.5%). Behavioral therapy alone also had the best safety profile.
“Behavioral treatments are recommended as a first-line therapy for OAB symptoms. Most physicians do not provide them, but they can be implemented by nurses, nurse practitioners, and physical therapists,” said lead author Kathryn L. Burgio, PhD, professor of medicine, division of gerontology and geriatric medicine, University of Alabama School of Medicine, Birmingham.
“Based on our findings, physicians might consider giving patients more treatment options and beginning with behavioral therapy.”