Group session teaching of behavioral modification program (BMP) for urinary incontinence: a randomized controlled trial among incontinent women

Abstract

Purpose: To determine effectiveness of Group BMP in managing female urinary incontinence (UI), using a standardized protocol taught to adult incontinent women.

Materials and methods: Forty-four adult women with slight to severe UI had baseline parameters collected (UI questionnaires, 3-day voiding diary, pelvic floor muscle strength testing, 24-h pad test, and cough stress test) and were randomized to a control group (CG) with no treatment and a treatment group (TG) who underwent a single group session lecture by two trained urology nurses on BMP followed 2-4 weeks later with individualized assessment of knowledge acquired and reinforcements if needed. The same baseline measures were collected after 6-8 weeks, and statistical analysis comparing changes within groups and between CG and TG were performed.

Results: Baseline data for both groups showed no statistically significant difference except for an age difference. At 6-8 weeks post-intervention, a statistically significant higher proportion of the TG (52.2%) improved when compared to the CG (16.7%). Also, the TG showed statistically significant improvement in 24-h voids, reduced leak diameter on cough test, improved pelvic muscle strength in pressure score, displacement, and duration, respectively, compared to their baseline pre-intervention data. The CG had only a statistically significant change for displacement score.

Conclusions: Group session teaching of BMP by trained urology nurses reduces UI severity, increases pelvic floor muscle strength, and reduces voiding frequency. This pilot study may precede establishment of single session Group BMP as both preventive and therapeutic for a cost-effective broad-based program in the future.