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| There are a number of causes of urge
urinary incontinence and a variety of strategies currently employed in its treatment.
Behavioral techniques, such as pelvic floor muscle rehabilitation and bladder training,
have been demonstrated effective in reducing incontinence, as have the use of electrical
stimulation and surgery. Pharmacologic management is an important part of the treatment
for urge urinary incontinence, and although there are a number of agents in use,
oxybutynin chloride is the most prescribed pharmacologic therapy for patients with an
overactive bladder. |
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- Behavioral
Interventions
- Two major categories of behavioral modification are employed
in the treatment of urge urinary incontinence: 1) pelvic floor muscle rehabilitation, and
2) bladder training.
- Pelvic Muscle
Rehabilitation
- Pelvic muscle rehabilitation involves implementation of a
comprehensive group of progressive exercises aimed at strengthening the levator muscle.
These exercises have been used to treat several types of urinary incontinence but are most
frequently employed in patients diagnosed with stress incontinence. The use of biofeedback
during exercise allows patients to observe the duration and strength of contractions. It
has been estimated that pelvic muscle rehabilitation produces complete resolution of
symptoms in 20% of patients and that improvements in incontinence are observed in 50% to
75% in most of those treated.
- Bladder Training
- Bladder training refers to a management regimen that involves
a strict schedule of voluntary voiding and employs techniques intended to delay responses
to urinary urgency. This type of treatment is typically used in patients with overactive
bladder and symptoms of urge urinary incontinence. It is estimated that while 50% of
patients have a substantial reduction of symptoms, fewer than 15% of patients experience
complete resolution of symptoms with bladder training strategies.
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