Effects of behavioral and drug therapy on nocturia in older incontinent women.
OBJECTIVE
To examine changes in nocturia from a multicomponent behavioral training program or drug therapy in older women with urge or mixed (urge-predominant) urinary incontinence.


METHODS
A secondary analysis of data from a prospective, randomized clinical trial.


METHODS
Parent trial was an outpatient research protocol in Alabama.


METHODS
One hundred ninety-seven women (aged 55-92) with incontinence and urodynamic evidence of bladder dysfunction. At baseline, 131 women (66% of participants) had nocturia.


METHODS
In the parent study, participants received behavioral training, including four sessions of biofeedback-assisted pelvic floor muscle exercises, drug treatment (oxybutynin IR titrated from 2.5 mg per day to 5.0 mg three times a day), or placebo.


METHODS
Participant-completed bladder diaries were used to calculate changes in nocturia.


RESULTS
Behavioral training reduced nocturia by a median 0.50 episodes per night and was significantly more effective than drug treatment (median reduction=0.30 episodes; P=.02) and placebo (median reduction=0.00 episodes; P<.001). Also, drug treatment was more effective than control (P=.007).


CONCLUSIONS
Both behavioral training and drug treatment reduced nocturia more than placebo, but behavioral training was the most effective.
Johnson
Theodore M
TM
Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Centers, Birmingham, Alabama, and Decatur, Georgia.
Burgio
Kathryn L
KL
Redden
David T
DT
Wright
Kate Clark
KC
Goode
Patricia S
PS
D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy; D001676:Biofeedback, Psychology; D005260:Female; D006801:Humans; D008333:Mandelic Acids / Q000627:therapeutic use; D008499:Medical Records; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000188:drug therapy / Q000628:therapy*; D014555:Urination Disorders / Q000188:drug therapy / Q000628:therapy*
D008333:Mandelic Acids; C005419:oxybutynin