Muscle training often useful for leaky bladder

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About half of women with stress urinary incontinence, a type of urine leakage that occurs with actions like coughing or laughing, benefit from training designed to strengthen the bladder muscles, according to a new study.

While this may not seem like great odds, there are ways of predicting which women will respond to such training, according to the report in the American Journal of Obstetrics and Gynecology.

Dr. Hendrik Cammu and colleagues, from Vrije University, Brussels, examined which patient characteristics predicted whether muscle training would be effective for stress urinary incontinence. A total of 447 women between the ages of 26 and 80 years were included in the study.

The participants received individual muscle training from the same physiotherapist. The women attended twice weekly, 30-minute sessions for 10 weeks.

Overall, 49 percent of women considered their treatment to be successful, while 51 percent experienced only some improvement, no change, or a worsening of their condition. Women in the successful group completed an average of 11 training sessions.

“The highest level of success was achieved in women who, before therapy, did not use a protective garment, who were not daily incontinent, or who did not leak at first cough,” Cammu and colleagues write. “The least success was achieved in women with symptoms for greater than five years, in women who were (receiving psychiatric drugs), and in women who had to wear diapers or more than two pads per day.”

Two or more leakages per day prior to treatment, long-term use of psychiatric drugs, and leaking at first cough were all strong predictors that muscle training wouldn’t work. When all three predictors were present, there was only a 15-percent chance that treatment would be successful.

SOURCE: American Journal of Obstetrics and Gynecology, November 2004.

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