Treatment of excessive urinary frequency and urgency by desensitization and progressive retention training

Abstract

A 20-yr-old male presenting a 2-yr history of excessive urinary urgency and frequency was treated with a three-phase behavioral intervention. Progressive urinary retention training was first suggested to decrease urinary frequency and increase functional bladder capacity (phase one). The patient was not able to comply with the instructions, showing a phobic fear of accidents and an over-valued consideration of the social consequences of incontinence. Systematic desensitization, in vivo desensitization and cognitive restructuring were implemented in phase two. The patient was then able to comply with the progressive urinary retention training (phase three) and completely overcame his problem. Gains were maintained at 6 and 12-month follow-ups. The results suggest that progressive urinary retention training alone is effective both at the behavioral and physiological levels, but its application is facilitated by a consideration and modification of the patient's subjective attitude towards excessive micturition frequency and its feared consequences.