Behavioral training for urinary incontinence in elderly ambulatory patients.
Research questions addressed by this study were: 1) Is the treatment of chronic urinary incontinence (UI) in elderly, nondemented ambulatory patients using bladder-sphincter biofeedback as effective when performed by an internist/geriatrician and a nurse practitioner as that reported by behavioral scientists?; and 2) how does bladder-sphincter biofeedback compare to a program of behavioral training that does not utilize biofeedback? Twenty-seven patients with UI were assigned based on the number of baseline accidents documented in a self-maintained log, their sex, and the predominant pattern of symptoms (urge or stress) to one of two treatment groups: biofeedback (13 patients) or behavioral training not utilizing biofeedback (14 patients). Patients were given up to six treatments. Patients in both groups achieved a highly significant (P less than .001) reduction in urinary accidents 1 month following treatments compared with their baseline number of accidents. The average reduction of accidents over this time period was 79% for the biofeedback group and 82% for the group receiving behavioral training without biofeedback. All patients showed improvement and no patient experienced any side effect. A internist/geriatrician and a geriatric nurse practitioner may achieve success utilizing behavioral therapy with or without biofeedback for the treatment of chronic urinary incontinence for ambulatory elderly patients.
Burton
J R
JR
Johns Hopkins University School of Medicine, Baltimore, Maryland.
Pearce
K L
KL
Burgio
K L
KL
Engel
B T
BT
Whitehead
W E
WE
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001521:Behavior Therapy / Q000379:methods*; D001676:Biofeedback, Psychology; D005260:Female; D005853:Geriatrics; D006801:Humans; D007388:Internal Medicine; D008297:Male; D009722:Nurse Practitioners; D014549:Urinary Incontinence / Q000628:therapy*; D014550:Urinary Incontinence, Stress / Q000628:therapy