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Study: Clinic-based behavioral programs as effective as electrical stimulation.
2003 AUG 7 - (NewsRx.com & NewsRx.net) -- Behavioral training for urinary stress incontinence (caused by stress such as coughing or sneezing) in a clinic-based program with or without pelvic floor electrical stimulation is more effective than self-help booklets, according to a study in the July 16, 2003, issue of the Journal of the American Medical Association (JAMA).
According to background information given in the JAMA paper, pelvic floor electrical stimulation (PFES) has been used for the treatment of urinary incontinence since 1952 and is widely used. PFES activates certain nerves causing contraction of muscles in the pelvic floor.
"This provides a form of passive exercise with the goal of improving the urethral closure mechanism. In addition, PFES can be useful in teaching pelvic floor muscle contraction to women who cannot identify or contract these muscles voluntarily because of extreme weakness," wrote Patricia S. Goode, MD, and colleagues. Goode is with the Department of Veterans Affairs Medical Center, and the Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama.,
Goode's team analyzed data from 200 women, aged 40 to 78 years with stress or mixed incontinence, to determine if PFES enhances the outcome of behavioral training in the treatment of stress incontinence.
The participants were randomly assigned to behavioral training (biofeedback-assisted pelvic floor muscle training, home exercises, bladder control strategies, and self-monitoring with bladder diaries), or the same program with the addition of home PFES treatments, or a control group consisting of self-administered behavioral training with a self-help booklet. For all patients, treatment was implemented over an 8-week period.
"Before treatment, the weekly frequency of incontinence was similar across the three groups," the researchers reported. "Behavioral training resulted in a mean (average) 68.6% reduction in frequency of episodes; behavioral training plus PFES, a mean 71.9% reduction; and treatment with the self-help booklet, a mean 52.5% reduction."
Goode and colleagues concluded, "The results of ...
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