Randomized clinical trial of efficacy of self-monitoring techniques to treat urinary incontinence in women.
OBJECTIVE
To assess the efficacy of self-monitoring techniques to reduce urine loss and increase quality of life for women with urinary incontinence.


METHODS
The design was a two arm, randomized, clinical trial with a wait list control group and 3-week intervention. Participants were 224 community-dwelling women 18 and older with UI. Self-monitoring was individualized counseling about fluid and caffeine intake, quick pelvic floor muscle contraction, voiding frequency, and management of constipation. The primary outcome measure was grams of urine loss. Secondary outcomes included episodes of urine loss, quality of life, and caffeine and fluid consumption.


RESULTS
The main effect of self-monitoring on grams of urine loss was significant. After adjusting for baseline urine loss, time in the intervention or in wait list group, age, hormone status, and race the self- monitoring group lost an average of 13.3 g less urine and had improved 26.1 points in quality of life compared to the wait list group. The effect of self-monitoring on episodes of urine loss was not significant in the total sample but was more effective for women who had 9 or more episodes of urine loss, were 65 years or older, and were premenopausal or taking hormone replacement therapy. Participants in the self-monitoring group reduced their caffeine intake, but did not increase their fluid intake compared to the wait list control group.


CONCLUSIONS
Since self-monitoring techniques are simple, safe, inexpensive, and within the scope of practice for most health professionals, they should be considered as first steps to treat women with UI.
Kincade
Jean E
JE
School of Medicine Program on Aging and School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Dougherty
Molly C
MC
School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Carlson
John R
JR
School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Hunter
Georgia S
GS
School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Busby-Whitehead
Jan
J
School of Medicine Program on Aging, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002110:Caffeine / Q000494:pharmacology; D000697:Central Nervous System Stimulants / Q000494:pharmacology; D004326:Drinking / Q000502:physiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011788:Quality of Life; D018401:Sample Size; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000523:psychology* / Q000628:therapy*
D000697:Central Nervous System Stimulants; D002110:Caffeine