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Randomized trial of a comparison of rehabilitation or drug therapy for urgency urinary incontinence: 1-year follow-up

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Abstract

Introduction and hypothesis

Our goal was to compare the long-term efficacy of bladder training (BT), pelvic floor muscle training (PFMT), combined pelvic floor rehabilitation (CPFR), and drug therapy (DT) in patients with urgency urinary incontinence (UUI).

Methods

This multicenter single-blind randomized controlled trial compared the efficacy of BT, PFMT, DT, and CPFR at baseline and 3- and 12-month follow-ups. Outcome measures included number of voids/24 h, number of UUI episodes, Quality of Life related to UUI (QOL-rUI), urogynecologic visual analog scale, and self-reported function and disability.

Results

A significant improvement was found for all treatment groups at 3 and 12 months in urinary frequency, UUI episodes, QOL-rUI, and number of daily pads. Only CPFR showed a significant decrease of 4 voids/24 h and a significant increase in self-reported function.

Conclusions

The study demonstrated long-term benefits of DT, BT, PFMT, and CPFR in the treatment of UUI with a slight advantage for CPFR.

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Abbreviations

DT:

Drug therapy

BT:

Bladder training

CPFR:

Combined pelvic floor rehabilitation

LLFDI:

Late-Life Function and Disability Instrument

PFMT:

Pelvic floor muscle training

QOL-rUI:

Quality of Life related to UUI

SUI:

Stress urinary incontinence

UI:

Urinary incontinence

UUI:

Urgency urinary incontinence

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Acknowledgment

We thank the physical therapists of Maccabi Healthcare Services specialized in pelvic floor rehabilitation and their clinic managers for participating in the study and managing the data collection process. We thank the managers of the Maccabi ‘Ramot’ clinic and their team and the management of Shefela-Jerusalem District for their support of this project. We also thank the gynecological and urogynecological physicians who referred patients to our study and managed the drug therapy group. A special acknowledgment is dedicated to Dr. Yossi Azuri, M.D., MHA, head of clinical studies unit in Maccabi Healthcare Services and his staff. This study was funded by Maccabbi Healthcare Services in Israel.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Physical Therapy, Schwartz Movement Analysis & Rehabilitation Laboratory, Physical Therapy Department, Recanati School for Community Health Professions, Faculty of Health Science, Ben-Gurion University of Negev, PO Box 653, Beer-Sheva, 84105, Israel

    Rachel Kafri & Itshak Melzer

  2. Research and Development, Physical Therapy Service, Maccabi Healthcare Services, Tel Aviv, Israel

    Daniel Deutscher

  3. Physical Therapy and Day Rehabilitation Center, Maccabi Healthcare Services, ‘Ramot’, Rishon LeZion, Israel

    Rachel Kafri & Jeffrey Shames

  4. Department of Urology, Sheba Medical Center, Tel HaShomer, Israel

    Jacob Golombp

Authors
  1. Rachel Kafri
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  2. Daniel Deutscher
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  3. Jeffrey Shames
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  4. Jacob Golombp
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  5. Itshak Melzer
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Corresponding author

Correspondence to Itshak Melzer.

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Kafri, R., Deutscher, D., Shames, J. et al. Randomized trial of a comparison of rehabilitation or drug therapy for urgency urinary incontinence: 1-year follow-up. Int Urogynecol J 24, 1181–1189 (2013). https://doi.org/10.1007/s00192-012-1992-8

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  • DOI: https://doi.org/10.1007/s00192-012-1992-8

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