Stress Urinary Incontinence
Conditions
Keywords
Stress urinary incontinence, Pelvic floor muscle training, Bladder training, Older women
Brief summary
To determine the effect of pelvic floor muscle training in women aged 70 years and over, who have proven stress urinary incontinence. The hypotheses to be tested are: 1. That pelvic floor muscle training is effective in relief of symptoms of stress urinary incontinence as measured by a greater reduction in the number of episodes of incontinence, quantity of urine lost and improvement of quality of life. 2. That women who undertake pelvic floor muscle training will show greater improvement of pelvic floor muscle function than women who have behavioural (bladder) training, as measured by real time transabdominal ultrasound.
Detailed description
Urinary incontinence is associated with significant personal stress, shame and social stigma and affects around one-third of women over 60 years of age. It restricts the amount of physical activity and can lead to social isolation and poor health. Pelvic floor muscle re-education by physiotherapists is the most commonly recommended method of conservative management. Although a recent Cochrane review concluded that it was an effective treatment for women with stress and mixed incontinence, there is still no strong evidence for the effectiveness of this intervention in elderly women. It has also been suggested that bladder training alone is equally effective in patients with stress urinary incontinence, urge and mixed incontinence. This is contrary to current clinical experience. It is therefore important to distinguish the relative effectiveness of these interventions used in isolation in order to ensure that urinary incontinence is managed in the most effective and efficient way. Comparisons: pelvic floor muscle training group and bladder training. Assessments will be conducted at baseline, 1 month, 3 months and 5 months during the intervention period. Both groups will then continue with their home program for a further 7 months until their final assessment (Assessment 5). Outcome measures will include: volume of urine lost during a stress test, completion of accident diaries, Degree of 'bother', quality of life using the Kings Health Questionnaire, and assessment of pelvic floor function using real time transabdominal diagnostic ultrasound.
Interventions
BEHAVIORALPelvic floor muscle training and bladder training
Sponsors
University of Melbourne
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Community-dwelling women aged over 65 years * urodynamically proven stress incontinence * Medically stable
Exclusion criteria
* Already receiving physiotherapy intervention * Neurogenic incontinence * Cannot comply with training program
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Quantity of urine lost over a 7-day period measured by self-report. | 1, 3, 5 (end of intervention) and 12 months | Self report of urine leakage |
| Urine lost on stress test measured by pad weigh test. | 1, 3, 5 (end of intervention) and 12 months | Pad weight following stress test |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Severity of stress incontinence | 1, 3, 5 (end of intervention) and 12 months | Severity of stress incontinence measured by the ICIQ-UI SF |
| Displacement of pelvic floor during muscle contraction | 1, 3, 5 (end of intervention) and 12 months | Displacement measured using transabdominal ultrasound imaging. |
| King's Health Questionnaire. | 1, 3, 5 (end of intervention) and 12 months | Quality of life questionnaire |
| Degree of bother | 1, 3, 5 (end of intervention) and 12 months | Visual Analogue Scale of degree of bother |
Countries
Australia
Outcome results
None listed