Urge-control strategies more essential for incontinence Tx than biofeedback. (Behavioral Treatment).

CHICAGO -- Biofeedback may not be an essential component of behavioral treatment for urge incontinence in older women, Kathryn L. Burgio, Ph.D., reported at the annual meeting of the American Urogynecologic Society.

Biofeedback-assisted behavioral training has been proved effective in treating urge incontinence. However, the biofeedback part, which requires expensive equipment and special expertise, is often the rate-limiting step. "It takes time, and a lot of physicians don't want to do it," Dr. Burgio, director of the University of Alabama continence program, Birmingham, said in an interview.

In a prospective clinical trial, 222 ambulatory women were randomized to one of three treatment groups for four visits during an 8-week period: biofeedback-assisted behavioral treatment, behavioral treatment with verbal feedback based on vaginal palpation, or self-administered behavioral treatment using a self-help booklet.

The women, aged 55-90 years, had either urge incontinence alone or mixed incontinence with urge predominant persisting for at least 3 months.

For the biofeedback-assisted behavior treatment, nurse-practitioners taught continence skills, including pelvic muscle education. Patients were advised to practice the skills at home and keep daily bladder diaries. They were ...