Skip Navigation
Department of Health and Human Services www.hhs.gov
 
Slide Tray
0 slides

Return to Slide Library

Slides

Add Presentation to Slide Tray Presentation:

Non-surgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness

Slide: 33 of 50

Continence and Improvement From Nonpharmacological Interventions for Urgency UI or Mixed UI

Nonpharmacological interventions improve severity and for patients with urgency UI, and both promote continence and improve severity for patients with mixed UI. Results from trials comparing interventions with placebo or no active intervention are given below.

Evaluation of 1 study of 131 participants that examined bladder training for ability to achieve continence in urgency UI provided insufficient evidence to permit a conclusion about the effect on continence rates. In 2 studies of 283 participants, reports of clinically important improvement in incontinence were 3.22-fold more likely with bladder training (statistically valid range from 2.25- to 4.6-fold) than for the control group, with 430 events per 1,000 treated patients (statistically valid range from 275 to 585 reports) attributable to the intervention. The strength of evidence for this finding is low.

There are no reports of continence rates resulting from percutaneous tibial nerve stimulation (PTNS). In 3 studies of 405 participants, reports of clinically important improvement in incontinence were 1.9-fold more likely with PTNS (statistically valid range from 1.00- to 15.49-fold) than for the control group, with 390 events per 1,000 treated patients (statistically valid range from 170 to 610 reports) attributable to the intervention. The strength of evidence for this finding is high.

For mixed UI treatments, analysis of 5 studies of 1,369 participants that evaluated combination treatment of PFMT plus bladder training for ability to achieve continence found that the rates of continence for groups using the intervention were 3.79-fold that of control groups, with a statistically valid range for the result from 1.55- to 9.27-fold. 166 reports of continence per 1,000 treated patients can be attributed to the intervention, with a statistically valid range for the outcome from 63 to 268 reports. The strength of evidence for this finding is high. In 4 studies of 1,171 participants, reports of clinically important improvement in incontinence were 4.13-fold more likely (statistically valid range from 1.58- to 10.78-fold) with PFMT plus bladder training than for the control group, with 387 events per 1,000 treated patients (statistically valid range from 171 to 603 reports) attributable to the intervention. The strength of evidence for this finding is high.

The evidence is insufficient to permit conclusions about the ability of weight loss and exercise to promote continence in patients with mixed UI. In 2 studies of 386 participants, reports of clinically important improvement in incontinence were 2.17-fold more likely with maintained weight loss and exercise (statistically valid range from 1.26- to 3.76-fold) than for the control group, with 273 reports per 1,000 treated patients (statistically valid range from 57 to 490 reports) attributable to the intervention. The strength of evidence for this finding is moderate.