Clinical Practice Guidelines: Rehabilitation Interventions for Urgency Urinary Incontinence, Urinary Urgency, and/or Urinary Frequency in Adult Women

Abstract

Background/Rationale: The body of evidence for interventions specific to urgency urinary incontinence (UUI), urinary urgency, and/or urinary frequency is not as readily accessible to consumers or health care providers when compared with stress urinary incontinence. This clinical practice guideline (CPG) is presented to help inform readers of the current evidence for physical therapy intervention of UUI, urinary urgency, and/or urinary frequency, as well as identify the areas in which further research is needed. Purpose of the CPG: The aim of this CPG is to provide evidence-based recommendations for rehabilitation interventions of UUI, urinary urgency, or urinary frequency in adult women. Methodology: Five electronic databases (OVID Medline, EMBASE, Cochrane Library, CINAHL, and ProQuest) were used to search for scientific literature published from January 1, 1995, to June 30, 2017. Critical readers formally assessed the procured articles. The authors collaborated to establish the levels of evidence and create the recommendations. Results: Thirty-one articles informed the development of 7 of the recommendations for intervention of UUI, urinary urgency, and/or urinary frequency. Summary tables of the articles that support each of the recommendations are presented. Two additional recommendations for best practice are presented as expert opinion. Conclusion: The CPG offers guidance to health care providers and patients for the treatment of urinary urge incontinence, urinary urgency, and urinary frequency. Recommendations, in order of strength of evidence, include behavioral interventions and pelvic floor muscle training (grade A) followed by electrical stimulation (grade B), and then lifestyle modifications (grades B and C). See the Supplemental Digital Content Video Abstract, available at: http://links.lww.com/JWHPT/A115.