Bladder training for urinary incontinence in adults

Abstract

Background: Bladder training is widely used for the treatment of urinary incontinence. It is generally used for the treatment of people with urge incontinence or detrusor instability, although it is also thought that it might be of use for people with mixed incontinence or stress incontinence.

Objectives: To assess the effects of bladder training for the treatment of urinary incontinence.

Search strategy: We searched the Cochrane Incontinence Group trials register up to July 1999. Date of the most recent search: July 1999.

Selection criteria: Randomised or quasi-randomised trials of bladder training for the treatment of incontinence.

Data collection and analysis: Two reviewers independently extracted data that were then cross-checked by the third reviewer. All three reviewers assessed trial quality.

Main results: We found seven eligible trials with a total of 259 predominantly female patients with urinary urge incontinence. The quality of trials was variable. Three trials involving 92 women compared bladder training with no bladder training. These tended to favour bladder training but data were available for only a limited number of pre-specified outcomes that varied across the three trials. No data describing long term follow up are available. One trial compared bladder training with drug therapy, but was inconclusive. Another trial compared bladder training with an electronic prompt device. The trial was small and included only 20 women. Data were not presented in a form suitable for quantitative analysis. Two further trials compared bladder training supplemented by drug therapy with bladder training alone. Again, the limited data provided insufficient evidence on which to draw conclusions.

Reviewer's conclusions: Bladder training may be helpful for the treatment of urinary urge incontinence, but this conclusion can only be tentative, based on the evidence available. There was not enough evidence to show whether drug therapy was better than bladder training or useful as a supplement to it.