Skip to main content

Advertisement

SpringerLink
Log in

Behavioral intervention: The first-line treatment for women with urinary incontinence

  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Urinary incontinence is a women’s health problem that imposes major consequences for personal quality of life and for national health care costs. The evidence base for the efficacy of the behavioral interventions of bladder training and pelvic muscle training to treat urinary incontinence in women is strong. Bladder and pelvic muscle training should be considered as basic health promotion education for all women. Screening for incontinence should be a routine component of women’s health care and bladder and pelvic muscle training should be prescribed by clinicians as a first-line treatment for women who screen positive. This article summarizes the relevant research and outlines intervention strategies that clinicians can readily translate into everyday practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Fantl JA, Newman DK, Colling J, et al.: Urinary Incontinence in Adults: Acute and Chronic Management. Rockville, MD: US Department of Health and Human Services; 1996. [AHCPR Publication No. 96-0682, Clinical Practice Guideline, No. 2, 1996 update].

    Google Scholar 

  2. Abrams P, Cardozo L, Khoury S, Wein A: Incontinence. 2nd International Consultation on Incontinence, July 1–3, 2001, edn2. Plymouth, UK: Plymbridge Distributors Ltd; 2002. The chapter on conservative treatment in women summarizes evidence-based protocols and tested devices.

    Google Scholar 

  3. Kegel AH: Progressive resistance exercise in the functional restoration of the perineal muscles. Am J Obstet Gynecol 1948, 56:238–249.

    PubMed  CAS  Google Scholar 

  4. Roe B, Williams K, Palmer M: Bladder training for urinary incontinence in adults (Cochrane Review). In The Cochrane Library, No 1. Oxford: Update Software Ltd.; 2002. This review on bladder training synthesizes the available evidence from randomized controlled trials for the efficacy of this strategy.

    Google Scholar 

  5. Hay-Smith EJ, Bo K, Berghmans LC, et al.: Pelvic floor muscle training for urinary incontinence in women (Cochrane Review). In The Cochrane Library, No 2. Oxford: Update Software Ltd.; 2002. This review on pelvic floor muscle training synthesizes the available evidence from randomized controlled trials for the efficacy of this strategy.

    Google Scholar 

  6. Hay-Smith J, Herbison P, Morkved S: Physical therapies for prevention of urinary and faecal incontinence in adults (Cochrane Review). Cochrane Database Syst Rev 2002, 2:CD003191.

    PubMed  Google Scholar 

  7. Jarvis GJ, Millar DR: Controlled trial of bladder drill for detrusor instability. BMJ 1980, 281:1322–1323.

    Article  PubMed  CAS  Google Scholar 

  8. Jarvis GJ: A controlled trial of bladder drill and drug therapy in the management of detrusor instability. Br J Urol 1981, 53:565–566.

    PubMed  CAS  Google Scholar 

  9. Fantl A, Wyman JF, McClish DK, et al.: Efficacy of bladder training in older women with urinary incontinence. JAMA 1991, 265:609–613.

    Article  PubMed  CAS  Google Scholar 

  10. Lagro-Janssen AL, Debruyne FM, Smits AJ, et al.: The effects of treatment of urinary incontinence in general practice. Fam Pract 1992, 9:284–289.

    Article  PubMed  CAS  Google Scholar 

  11. Nygaard I, Kreder K, Lepic M, et al.: Efficacy of pelvic floor muscle exercises in women with stress, urge and mixed urinary incontinence. Am J Obstet Gynecol 1996, 174:120–125.

    Article  PubMed  CAS  Google Scholar 

  12. Burgio KL, Locher JL, Goode PS, et al.: Behavioral vs. drug treatment for urge urinary incontinence in older women. JAMA 1998, 280:1995–2000.

    Article  PubMed  CAS  Google Scholar 

  13. Bo K, Talseth T, Holme I: Single-blind, randomized controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones and no treatment in management of genuine stress incontinence in women. BMJ 1999, 318:487–493.

    PubMed  CAS  Google Scholar 

  14. Yamanishi T, Yasuda K, Sakakibara R, et al.: Randomized, doubleblind study of electrical stimulation for urinary incontinency due to detrusor overactivity. Urology 2000, 55:353–357.

    Article  PubMed  CAS  Google Scholar 

  15. Pages IH, Jahr S, Scaufele MK, Conradi E: Comparative analysis of biofeedback and physical therapy for treatment of urinary incontinence in women. Am J Phys Med Rehab 2001, 80:494–502.

    Article  CAS  Google Scholar 

  16. Dougherty M, Bishop K, Mooney R, et al.: Graded pelvic muscle exercise: effect on stress urinary incontinence. J Reprod Med 1993, 39:684–691.

    Google Scholar 

  17. Burns P, Pranikoff K, Nochajski T, et al.: A comparison of effectiveness of biofeedback and pelvic muscle exercise treatment of stress incontinence in older communitydwelling women. J Gerontol 1993, 48:M167-M174.

    PubMed  CAS  Google Scholar 

  18. Miller JM, Ashton-Miller JA, DeLancey JO: A pelvic muscle precontraction can reduce cough-related urine loss in selected women with mild SUI. J Am Geriatr Soc 1998, 46:870–874.

    PubMed  CAS  Google Scholar 

  19. Dattilo J: A long-term study of patient outcomes with pelvic muscle re-education for urinary incontinence. J Wound Ostomy Continence Nurs 2001, 28:199–205.

    PubMed  CAS  Google Scholar 

  20. Bo K, Talseth T: Long-term effect of pelvic floor muscle exercise 5 years after cessation of organized training. Obstet Gynecol 1996, 87:261–265.

    Article  PubMed  CAS  Google Scholar 

  21. DeLancey JO, Sampselle CM, Punch MR: Kegel dyspareunia: levator ani myalgia caused by overexertion. Obstet Gynecol 1993, 82:658–659.

    Article  PubMed  CAS  Google Scholar 

  22. Morkved S, Bo K: Effect of postpartum pelvic floor muscle training in prevention and treatment of urinary incontinence: a one-year follow up. Br J Obstet Gynecol 2000, 107:1022–1028.

    CAS  Google Scholar 

  23. Sampselle CM, Miller JM, Mims BL, et al.: Effect of pelvic muscle exercise on transient incontinence during pregnancy and after birth. Obstet Gynecol 1998, 91:406–412.

    Article  PubMed  CAS  Google Scholar 

  24. Meyer S, Hohlfeld P, Achtari C, De Grandi P: Pelvic floor education after vaginal delivery. Obstet Gynecol 2001, 97:673–677.

    Article  PubMed  CAS  Google Scholar 

  25. Reilly ET, Freeman RM, Waterfield MR, et al.: Prevention of postpartum stress incontinence in primigravidae with increased bladder neck mobility: a randomized controlled trial of antenatal pelvic floor exercises. BJOG 2002, 109:68–76.

    Article  PubMed  CAS  Google Scholar 

  26. Mokved S, Bo K, Schei B, Salvesen KA: Pelvic floor muscle training during pregnancy to prevent urinary incontinence: a single-blind, randomized, controlled trial. Obstet Gynecol 2003, 101:313–319.

    Article  Google Scholar 

  27. Wyman JF, Fantl JA, McClish DK, Bump RC: Comparative efficacy of behavioral interventions in the management of female urinary incontinence. Am J Obstet Gynecol 1998, 179:999–1007.

    Article  PubMed  CAS  Google Scholar 

  28. Holtedahl K, Verelst M, Schiefloe A: A population-based, randomized, controlled trial of conservative treatment for urinary incontinence in women. Acta Obstet Gynecol Scand 1998, 77:671–677.

    Article  PubMed  CAS  Google Scholar 

  29. Dougherty MC, Dwyer JW, Pendergast JF, et al.: A randomized trial of behavioral management for continence with older rural women. Res Nurs Health 2002, 25:3–13.

    Article  PubMed  Google Scholar 

  30. Sampselle CM, Wyman JF, Thomas KK, et al.: Continence for women: a test of AWHONN’s evidence-based protocol. J Obstet Gynecol Neonatal Nurs 2000, 29:9–17.

    Article  PubMed  CAS  Google Scholar 

  31. Burgio KL, Ives DG, Locher JL, Arena VC: Treatment seeking for urinary incontinence in adults. J Am Geriatr Soc 1994, 42:208–212.

    PubMed  CAS  Google Scholar 

  32. Goldstein M, Hawthorne ME, Engeberg S, et al.: Urinary incontinence: why people do not seek help. J Gerontol Nurs 1992, 18:15–20.

    PubMed  CAS  Google Scholar 

  33. Sampselle CM, Miller JM: Pelvic muscle exercise: effective patient teaching. Female Patient 1996, 21:29–36.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Nursing, University of Michigan, 400 North Ingalls, Room 4236, 48109-0482, Ann Arbor, MI, USA

    Carolyn M. Sampselle PhD, RNC

Authors
  1. Carolyn M. Sampselle PhD, RNC
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sampselle, C.M. Behavioral intervention: The first-line treatment for women with urinary incontinence. Curr Urol Rep 4, 356–361 (2003). https://doi.org/10.1007/s11934-003-0006-2

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11934-003-0006-2

Keywords

Search

Navigation