Predictors of outcome in the behavioral treatment of urinary incontinence in women.
OBJECTIVE
To identify predictors of outcome of a multicomponent behavioral training program for urge and stress incontinence in women.


METHODS
This report is a secondary analysis of data from three prospective, randomized, clinical trials testing behavioral interventions for urinary incontinence. Participants were a volunteer sample of 258 ambulatory, nondemented, community-dwelling women, aged 40-92 years, with stress, urge, or mixed urinary incontinence. Participants received 8 weeks (four visits) of multicomponent behavioral training in each study. The relationship between a number of variables and treatment success were explored by univariate and multivariable logistic regression analyses.


RESULTS
Successful treatment of predominantly urge incontinence (75% reduction of incontinent episodes as recorded on bladder diary) was associated with not wearing any form of protection for incontinence (P = .045; 95% confidence interval [CI] .282, .987). Achieving total continence (100% reduction) was associated with fewer incontinent episodes at baseline (P < .001; 95% CI .138, .557), previous surgery for incontinence (P = .021; 95% CI 1.169, 6.543), and lower education level (P = .022; 95% CI .175, .871). Successful treatment of predominantly stress incontinence (75% reduction) was related to not having previous evaluation or treatment for incontinence (P = .001; 95% CI .026, .415), and fewer incontinent episodes on baseline bladder diary (P = .026; 95% CI .210, .907). Outcomes were not associated with age, race, type of incontinence, or a number of other variables reflecting medical history, obstetric history, medications, pelvic examination, body mass index, urodynamic parameters, or psychological distress.


CONCLUSIONS
Aside from indicators of severity and previous treatment, there were few associations between baseline clinical variables and outcome of behavioral treatment.
Burgio
Kathryn L
KL
Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Birmingham, Alabama 35233, USA. kburgio@aging.uab.edu
Goode
Patricia S
PS
Locher
Julie L
JL
Richter
Holly E
HE
Roth
David L
DL
Wright
Kate Clark
KC
Varner
R Edward
RE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000628:therapy*