ABSTRACT
Urinary incontinence (UI) is one of the most prevalent and costly health problems in the United States. Women participating in two clinical trials had experienced UI for a mean of 7.2 +/- 7.6 SD years. Hormone status, gynecologic surgery, alcohol intake, age, and educational attainment were significantly related to amount of urine loss. Amount of urine loss was also related to episodes of urine loss, caffeine and fluid intake, and quality of life.
Subject(s)
Urinary Incontinence/prevention & control , Adolescent , Adult , Age Distribution , Aged , Caffeine , Constipation/complications , Drinking Behavior , Female , Health Status , Humans , Middle Aged , Quality of Life , Risk Factors , Socioeconomic Factors , Urinary Incontinence/etiologyABSTRACT
AIM: 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.
Subject(s)
Urinary Incontinence/psychology , Urinary Incontinence/therapy , Adolescent , Adult , Aged , Caffeine/pharmacology , Central Nervous System Stimulants/pharmacology , Drinking/physiology , Female , Humans , Middle Aged , Monitoring, Physiologic , Quality of Life , Sample Size , Treatment OutcomeABSTRACT
Urinary incontinence (UI) is a common chronic condition among women. Treatment of UI can involve behavioral techniques, pharmacological strategies, or surgical intervention. Clinically, treatment strategies should start with the simplest and least invasive measures. To overcome the deficiencies in previous research and provide definitive information for clinical practice, a randomized clinical trial is currently underway. This clinical trial uses a pretest-posttest design to first determine the effectiveness of self-monitoring techniques before subjects are randomized into one of two treatment groups or an attentional control group with a 1-year followup. The study design, sampling plan, and interventions used in an ongoing clinical trial to assess the effectiveness of self-monitoring and efficacy of biofeedback to treat UI in women are described. Innovative techniques to assess adherence to the pelvic muscle exercise protocol are addressed.
