Aspects of physiotherapy and behavior therapy used in each visit:
Assessment of an individualized urge profile
All women received an unvalidated questionnaire to analyze certain patterns of behavior regarding symptoms of urgency. Women were asked to look into their typical urgency-related behavior patterns. Nutrition-related habits as well as day to day and business-related characteristics were analyzed.
The voiding diary, which was mandatory to all participating women had to be used for at least 14 consecutive days. Women received detailed information about how to complete the voiding diary. A self-assessment of urgency symptoms is known to be crucial for a successful therapy.
Insights into physiological aspects of bladder function and onset of urgency
Detailed and subject-adapted information was given to all women participating to determine all causes and effects of urgency. What does an increase of abdominal pressure do? What does the detrusor actually do? Valsalva during micturition should be avoided, regardless of whether this is voluntary or accidental. Women received information about urgency-inducing food and drinks as well.
Urgency-control techniques and management in situations of urgency
Another strategy was the use of urgency-control techniques or delay strategies. One idea is to deactivate a so-called “last-minute-symptom” to reach the toilet dry. Another aim is to achieve an increased volume of bladder capacity. An individualized training was performed with each participating woman.
Change of behavior and abolish malconditioning
Aim of this issue was to stop certain behavior patterns which can be described as malconditioning. “Whenever I arrive at home, the first I do is go to the toilet.” To retrieve bladder control was the major task of this part of the therapy.
Physiotherapy and pelvic floor training
Awareness of pelvic floor muscles and sphincters is crucial for successful training. Improvement of perception was one of the key points. Breathing techniques, bearing and ways to deal with intra-abdominal pressure were taught. All women who agreed underwent vaginal examination by the physiotherapist to assess pelvic floor muscle status.
Acquisition of pressure-decreasing and physiological daily routine
Another part of the physiotherapy visits involved learning to decrease intra-abdominal pressure in daily routine, trying to decrease nocturia episodes, learning how to get up at night with avoiding “last-minute-symptoms”.
Physical procedures such as warmth, reflexology, specific clothing
This takes into account the fact that a lot of OAB-women report an increase of symptoms during cold rainy weather.
Relaxation and body perception
This contains specific pelvic floor training and awareness.