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Updated: Jun 17, 2025

Detrusor Underactivity Model in Rats by Conus Medullaris Transection
Published on: August 28, 2020
Isolated bladder training or in combination with other therapies to improve overactive bladder symptoms: a systematic
A K Rocha1, S Monteiro2, I Campos1
1Postgraduate Program in Rehabilitation Sciences, Institute of Motricity Sciences, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil.
Background:
Bladder training (BT), the maintenance of a scheduled voiding regime at gradually adjusted intervals, is a common treatment for overactive bladder (OAB).
Objectives:
To assess the effects of isolated BT and/or in combination with other therapies on OAB symptoms.
Methods:
A systematic review of eight databases was conducted. After screening titles and abstracts, full texts were retrieved. Cochrane RoB 2 and the GRADE approach were used.
Results:
Fourteen RCTs were included: they studied isolated BT (n = 11), BT plus drug treatment (DT; n = 5), BT plus intravaginal electrical stimulation (IVES; n = 2), BT plus biofeedback and IVES (n = 1), BT plus pelvic floor muscle training and behavioral therapy (n = 2), BT plus percutaneous tibial nerve stimulation, and BT plus transcutaneous tibial nerve stimulation (n = 1). In a meta-analysis of short-term follow-up data, BT plus IVES resulted in greater improvement in nocturia (mean difference [MD]: 0.89, 95% CI: 0.5, 1.20), urinary incontinence (UI; MD: 1.93, 95% CI: 1.32, 2.55), and quality of life (QoL; MD: 4.87, 95% CI: 2.24, 7.50) than isolated BT, while DT and BT improved UI (MD: 0.58, 95% CI: 0.23, 0.92) more than isolated BT.
Conclusion:
In the short term, BT plus IVES improves the OAB symptoms of nocturia and UI while improving QoL. The limited number of RCTs and heterogeneity among them provide a low level of evidence, making the effect of BT on OAB inconclusive, which suggests that new RCTs should be performed.
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