Muscle, bladder training may resolve urinary incontinence

Pelvic floor muscle training plus bladder training appear to resolve urinary incontinence, according to a new systematic review of published studies on non-surgical management of urinary incontinence in women.

The study, published in an online edition of Annals of Internal Medicine, also showed that pelvic floor muscle training alone resolved or improved urinary incontinence compared with regular or ordinary care, and that immediate-release oxybutynin (Ditropan) and extended-release tolterodine (Detrol LA) resolved urinary incontinence better than placebo.

Among other conclusions of the analysis of urinary continence management techniques:

• Injectable bulking agents and medical devices were associated with similar continence and improvement rates.
  
  

• Electrical stimulation failed to resolve urinary incontinence.
  
  

• Administering oral hormones increased rates of urinary incontinence compared with placebo.
  
  

• Transdermal or vaginal estrogen resulted in inconsistent improvement of symptoms.
  
  

• Adrenergic drugs, which accelerate heart rate, did not resolve or improve symptoms.
  

”Buried in the bad news of widespread use of many products that don’t work is some very good news,” said co-author Robert L. Kane, MD, of the University of Minnesota School of Public Health, Minneapolis. “The data show that intensive lifestyle changes, like losing weight through diet and exercise, would avoid 54 cases of stress urinary incontinence per 1,000 treated women, but it is unlikely women would stick with such a regimen just to avoid incontinence.

“Pelvic floor muscle training would resolve 490 cases of stress urinary incontinence per 1,000 treated women, 80 cases of any urinary incontinence, and 167 cases of stress or urge urinary incontinence per 1,000 treated women.”