Group learning behavior modification and exercise for women with urinary incontinence

Can group learning be effective in reducing symptoms of urinary incontinence? Would women with stress incontinence respond more favorably than women with urge incontinence? Would age make a difference? Would women with various ethnic backgrounds attend the sessions?

Eighty-five women between the ages of 40 and 78 years attended a 2-hour class offered at two sites. The class covered anatomy and physiology, causes of incontinence, treatment/management alternative (including behavioral methods and dietary changes), and specific exercises to identify pelvic muscles. Women filled out a questionnaire before the training and 1 month after the training. Telephone interviews were conducted at 3 and 6 months after the training.

Thirty-eight women (45%) completed the posttraining questionnaire. Some were lost to follow-up at 3 and 6 months. There was a significant reduction in the number of absorbency products used, especially during the day. Women with stress incontinence had a significant decrease in urine loss. Women with urge incontinence showed a significant decrease in urine loss, not to the same extent, but many did not have to hurry to the toilet. Younger women (59 years) reported reduced wetness at 1 and 3 months. Older women improved at 1 month, not at 3 months, and saw a trend toward improvement again at 6 months. Eighty-four percent of those attending the class were white. Others were Hispanic, Native American, Asian, and black.

Although limitations to the study were identified, group training was seen as an effective means to educate women about incontinence management and to have them take an active role. Several recommendations followed the study: to increase the number of classes with an optional one-on-one follow-up appointment, to use biofeedback equipment for those patients who have difficulty identifying appropriate muscle groups, to develop an education program focusing on prevention of incontinence, and to develop a rehabilitation program for those patients who require surgery.