title: Behavioral treatment of exercise-induced urinary incontinence among female soldiers.
abstract: One-third of 450 female soldiers surveyed indicated that they experienced problematic urinary incontinence during exercise and field training activities. The other crucial finding of this survey was probably that 13.3% of the respondents restricted fluids significantly while participating in field exercises. Although only 5.3% of respondents felt that their urine leakage had a significant impact on their regular duties, it is obvious that many more are sufficiently worried about leakage to put themselves at significant risk for dehydration-related injuries. This study tested whether behavioral interventions effective among older people could help younger soldiers. Thirty-nine female soldiers reporting exercise-induced urinary incontinence underwent urodynamic assessments of bladder capacity, urethral closure pressure, and detrusor contraction pressures as well as a symptom questionnaire before and after therapy. They were stratified by diagnosis of physical stress incontinence or mixed urge/stress incontinence and randomized into two groups. Twenty-three participants performed pelvic muscle exercises with urethral biofeedback for 8 weeks, and 16 participants performed pelvic muscle exercises alone. Patient reports as well as the post-treatment examinations indicated that all subjects improved significantly. Only five subjects in the biofeedback/exercise and three in the exercise-only group desired further treatment. All subjects initially diagnosed with detrusor dysfunction had normal readings at the end of the study. Thus, behavioral treatments can be effective against exercise-induced urinary incontinence among most female soldiers.
authors.affiliation: Department of Clinical Investigation, Madigan Army Medical Center, Tacoma, WA 98431, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Sherman
authors.forename: G D
authors.initials: GD
authors.lastname: Davis
authors.forename: M F
authors.initials: MF
authors.lastname: Wong
mesh_terms: D000328:Adult; D001676:Biofeedback, Psychology / Q000379:methods*; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D008889:Military Personnel; D017773:Pelvic Floor; D011795:Surveys and Questionnaires; D014550:Urinary Incontinence, Stress / Q000209:etiology* / Q000534:rehabilitation*; D014563:Urodynamics; D014931:Women, Working