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Behavioral training for urinary incontinence in elderly ambulatory patients
J R Burton1, K L Pearce, K L Burgio
1Johns Hopkins University School of Medicine, Baltimore, Maryland.
Journal of the American Geriatrics Society
|August 1, 1988
Summary
Elderly patients with chronic urinary incontinence (UI) improved significantly with behavioral therapy, whether using bladder-sphincter biofeedback or not. This treatment, administered by internists/geriatricians and nurse practitioners, proved effective and safe for ambulatory, nondemented individuals.
Area of Science:
- Geriatrics
- Urology
- Behavioral Medicine
Background:
- Chronic urinary incontinence (UI) significantly impacts the quality of life for elderly, ambulatory patients.
- Current treatment options for UI in this demographic often involve behavioral interventions.
- Investigating the efficacy of biofeedback-assisted behavioral therapy compared to non-biofeedback methods is crucial for optimizing geriatric care.
Purpose of the Study:
- To evaluate the effectiveness of bladder-sphincter biofeedback for chronic UI in elderly patients when administered by primary care providers (internist/geriatrician and nurse practitioner).
- To compare the efficacy of bladder-sphincter biofeedback with a behavioral training program that does not utilize biofeedback.
- To assess the safety and tolerability of these interventions in the target population.
Main Methods:
- A total of 27 elderly, nondemented, ambulatory patients with chronic UI were enrolled.
- Patients were randomized into two groups: bladder-sphincter biofeedback (13 patients) or behavioral training without biofeedback (14 patients).
- Treatment involved up to six sessions, with outcomes assessed by the reduction in urinary accidents after one month.
Main Results:
- Both treatment groups demonstrated a highly significant reduction (P < .001) in urinary accidents one month post-intervention.
- The biofeedback group achieved an average reduction of 79% in urinary accidents.
- The non-biofeedback behavioral training group showed an average reduction of 82%, with all patients experiencing improvement and no reported side effects.
Conclusions:
- Bladder-sphincter biofeedback is an effective treatment for chronic UI in elderly ambulatory patients when delivered by internists/geriatricians and nurse practitioners.
- Behavioral training without biofeedback is equally effective and demonstrates comparable outcomes.
- These findings support the integration of non-pharmacological, behavioral interventions for managing urinary incontinence in geriatric primary care settings.