Efficacy Of Bladder Training Research Articles

Randomized controlled trial on the efficacy of bladder training before removing the indwelling urinary catheter in patients with acute urinary retention associated with benign prostatic hyperplasia

Objective.The aim of this study was to investigate the efficacy of bladder training before removing the indwelling urinary catheter in patients with acute urinary retention (AUR) associated with benign prostatic hyperplasia (BPH). Material and methods. In total, 845 consecutive patients with their first episode of spontaneous AUR associated with BPH were enrolled in this prospective randomized controlled trial. They were randomly assigned to be given either pharmacological treatment combined with bladder training or pharmacological treatment (tamsulosin 0.2 mg and finasteride 5 mg once daily) with free drainage of urinary catheter for 7 days, and a trial without catheter (TWOC) was performed. Data on patients' baseline demographics, history of BPH, International Prostate Symptom Score, prostate size, serum prostate-specific antigen, intravesical prostatic protrusion, TWOC success rates and related complications were collected and statistically analysed. Results.The two groups of spontaneous AUR patients with BPH were given pharmacological treatment combined with bladder training before catheter removal (n = 440) or pharmacological treatment alone (n = 405) for 7 days. All 845 patients underwent a first TWOC with an overall success rate of 66.9% after first 7 days' catheterization; TWOC was successful in 65.2% of cases in the intervention group and 68.6% in the control group. There was no statistically significant difference in TWOC success rate between the two groups (p > 0.05). Conclusion. This randomized controlled trial showed that bladder training before urinary catheter removal did not increase the chance of TWOC success significantly in spontaneous AUR patients with BPH.

The Effectiveness of Bladder Training in Overactive Bladder

Overactive bladder (OAB) is often a cause of depression, social isolation and a decline in general health and quality of life. The International Consultation on Incontinence guidelines recommend pharmacotherapy and behavioral therapy as a first-line therapy in OAB patients. Behavioral therapy modalities include dietary modification, pelvic floor muscle exercise, biofeedback, and bladder training (BT) among other bladder control programs. Pharmacotherapy and neuromodulation can be added if these measures fail to control symptoms. Behavioral intervention is suitable for primary care setting. The efficacy of BT on OAB symptoms has been reported as resolution of symptoms ranging from 12 % to 90 %, and improvement ranging from 57 % to 87 %. However, such protocols for BT vary from study to study, and not many studies report on its efficacy on OAB. Considering the increasing prevalence of OAB and the increasing need for a systematized protocol for BT we aimed to provide an overview of evidence supporting BT for OAB patients, to examine its efficacy, and to provide useful information on its clinical application.

Randomized trial of a comparison of rehabilitation or drug therapy for urgency urinary incontinence: 1-year follow-up

Our goal was to compare the long-term efficacy of bladder training (BT), pelvic floor muscle training (PFMT), combined pelvic floor rehabilitation (CPFR), and drug therapy (DT) in patients with urgency urinary incontinence (UUI). This multicenter single-blind randomized controlled trial compared the efficacy of BT, PFMT, DT, and CPFR at baseline and 3- and 12-month follow-ups. Outcome measures included number of voids/24 h, number of UUI episodes, Quality of Life related to UUI (QOL-rUI), urogynecologic visual analog scale, and self-reported function and disability. A significant improvement was found for all treatment groups at 3 and 12 months in urinary frequency, UUI episodes, QOL-rUI, and number of daily pads. Only CPFR showed a significant decrease of 4 voids/24 h and a significant increase in self-reported function. The study demonstrated long-term benefits of DT, BT, PFMT, and CPFR in the treatment of UUI with a slight advantage for CPFR.

BLADDER DYSFUNCTION AFTER ACUTE URINARY RETENTION IN RATS

We investigated bladder function in acute urinary retention and subsequent catheterization in rat bladders. The penile urethra in rats was clamped with a small clip and cystostomy was performed to infuse 3 ml. of saline for inducing acute urinary retention. At 30 minutes after the induction of urinary retention the cystostomy was opened to empty the bladder. In functional studies contractile responses to carbachol were measured in group 1-before, group 2-at 3 ml. of urinary retention, group 3-at 3 ml. of urinary retention exposed for 30 minutes and group 4-30 minutes after catheterization. Moreover, in vivo real-time monitoring of blood flow and vesical pressure were measured in the bladders with a laser Doppler flowmeter and cystometrography, respectively. Malonaldehyde and 4-hydroxyalkenals were measured by colorimetric assay in these groups. In functional studies the mean maximum contractile response value plus or minus standard deviation of carbachol-to-bladder in groups 1 to 4 was 11.8 +/- 1.3, 11.9 +/- 1.7, 9.8 +/- 0.8 and 6.9 +/- 0.7 gm./mm.2, respectively. In real-time monitoring of blood flow and vesical pressure acute urinary retention significantly decreased blood flow and increased vesical pressure, and subsequent catheterization increased blood flow and decreased vesical pressure in the bladders. The concentrations of malonaldehyde and 4-hydroxyalkenals in the bladders in group 4 were significantly higher than in the other groups. Our data indicate that bladder dysfunction after catheterization is partially caused by free radicals, which have an important role in bladder dysfunction during acute urinary retention.

Quality of Life Following Bladder Training in Older Women With Urinary Incontinence

No AccessJournal of UrologyUrological Survey: Abstracts: Voiding Function and Dysfunction, and Female Urology1 Dec 1998Quality of Life Following Bladder Training in Older Women With Urinary Incontinence J.F. Wyman, J.A. Fantl, D.K. McClish, S.W. Harkins, J.S. Uebersax, and M.G. Ory J.F. WymanJ.F. Wyman More articles by this author , J.A. FantlJ.A. Fantl More articles by this author , D.K. McClishD.K. McClish More articles by this author , S.W. HarkinsS.W. Harkins More articles by this author , J.S. UebersaxJ.S. Uebersax More articles by this author , and M.G. OryM.G. Ory More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62338-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Quality of Life Following Bladder Training in Older Women With Urinary Incontinence." The Journal of Urology, 160(6 Part 1), p. 2304 References 1 : Efficacy of bladder training in older women with urinary incontinence. J.A.M.A.1991; 256: 609. Google Scholar Virginia Commonwealth University, Richmond, Virginia, Wake Forest University, Winston-Salem, North Carolina, and National Institute of Aging, National Institutes of Health, Bethesda, Maryland© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 160Issue 6 Part 1December 1998Page: 2304 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information J.F. Wyman More articles by this author J.A. Fantl More articles by this author D.K. McClish More articles by this author S.W. Harkins More articles by this author J.S. Uebersax More articles by this author M.G. Ory More articles by this author Expand All Advertisement PDF downloadLoading ...

Favorable Outcome of Pubovaginal Slings for Geriatric Women With Stress Incontinence

Traditionally pubovaginal slings have been associated with a greater risk of immediate morbidity and prolonged voiding dysfunction compared to other stress incontinence repairs. Because elderly patients already have inherently greater perioperative risk and prevalence of innate voiding dysfunction, there is some reluctance to construct slings in this age group. We examined the outcome of pubovaginal sling in elderly women versus younger controls to determine whether this concern is justified. We retrospectively analyzed the outcome of 19 geriatric women older than 70 years who underwent a pubovaginal sling procedure between 1992 and 1995, and compared the findings to those of 77 younger control women with a mean followup of 22 months. All women had video urodynamically proved stress incontinence due to intrinsic sphincter deficiency and many had coexistent bladder instability symptoms. Women with neurogenic causes for incontinence were excluded from the study. Stress incontinence resolved in 100% of geriatric and 97% of control women. Preoperative instability symptoms, including urge incontinence, improved in more than 50% of patients in both groups. De novo instability symptoms arose in 10% of women in each group but were generally controlled with anticholinergics. Efficient voiding resumed within a mean of 16 days in both groups. The morbidity and success rates of pubovaginal sling surgery in the elderly compare favorably to those in younger women. Advanced age alone would not dissuade us from constructing a pubovaginal sling when indicated.

Biofeedback for the Treatment of Stress and Urge Incontinence

No AccessJournal of UrologyClinical Urology: Original Articles1 Mar 1995Biofeedback for the Treatment of Stress and Urge Incontinence Mark Stein, William Discippio, Michael Davia, Harvey Taub, and Shlomo Raz Mark SteinMark Stein More articles by this author , William DiscippioWilliam Discippio More articles by this author , Michael DaviaMichael Davia More articles by this author , Harvey TaubHarvey Taub More articles by this author , and Shlomo RazShlomo Raz More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)67671-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail References 1 : Efficacy of bladder training in older women with urinary incontinence. J.A.M.A.1991; 265: 609. Google Scholar 2 National Institutes of Health Consensus Conference on Urinary Incontinence in Adults. Secaucus, New Jersey, 1989. Google Scholar 3 : Biofeedback therapy for female incontinence due to low urethral resistance. J. Urol.1990; 143: 1205. Abstract, Google Scholar 4 Sand, P. K. and Wheeler, J. S.: Transvaginal electrical stimulation for incontinence. In: InCare Instruction Manual. Illinois: InCare Medical Products. Google Scholar 5 : Intravesical transurethral bladder stimulation to increase bladder capacity. J. Urol.1989; 142: 600. Link, Google Scholar 6 : Physiologic therapy for stress urinary incontinence. J.A.M.A.1951; 146: 915. Google Scholar 7 : Treatment of stress incontinence with pelvic floor exercises and biofeedback. J. Amer. Geriatr. Soc.1990; 38: 341. Google Scholar 8 : Biofeedback-assisted behavioral training for elderly men and women. J. Amer. Geriatr. Soc.1990; 38: 338. Google Scholar 9 : Biofeedback therapy technique for treatment of urinary incontinence. Urology1991; 37: 432. Google Scholar 10 : Placebo--the drug of choice in female motor urge incontinence? Brit. J. Urol.1983; 55: 34. Google Scholar 11 : Assessment of Kegel pelvic exercise performance after brief verbal instruction. Amer. J. Obst. Gynec.1991; 165: 322. Google Scholar Departments of Urology and Psychology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New YorkDepartment of Surgery/Urology, UCLA School of Medicine, Los Angeles, California.© 1995 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMcKENNA P, HERNDON C, CONNERY S and FERRER F (2018) PELVIC FLOOR MUSCLE RETRAINING FOR PEDIATRIC VOIDING DYSFUNCTION USING INTERACTIVE COMPUTER GAMESJournal of Urology, VOL. 162, NO. 3 Part 2, (1056-1062), Online publication date: 1-Sep-1999.SCHMIDT R, JONAS U, OLESON K, JANKNEGT R, HASSOUNA M, SIEGEL S and van KERREBROECK P (2018) SACRAL NERVE STIMULATION FOR TREATMENT OF REFRACTORY URINARY URGE INCONTINENCEJournal of Urology, VOL. 162, NO. 2, (352-357), Online publication date: 1-Aug-1999. Volume 153Issue 3March 1995Page: 641-643 Advertisement Copyright & Permissions© 1995 by American Urological Association, Inc.MetricsAuthor Information Mark Stein More articles by this author William Discippio More articles by this author Michael Davia More articles by this author Harvey Taub More articles by this author Shlomo Raz More articles by this author Expand All Advertisement PDF downloadLoading ...

Bladder training reduced urinary incontinence in older women

Source Citation Fantl JA, Wyman JF, McClish DK, et al. Efficacy of bladder training in older women with urinary incontinence. JAMA. 1991;265:609-13.

Efficacy of Bladder Training in Older Women With Urinary Incontinence

The efficacy of bladder training was evaluated in a randomized clinical trial involving 123 noninstitutionalized women 55 years and older with urinary incontinence. Subjects were urodynamically categorized as those with urethral sphincteric incompetence (N = 88) and those with detrusor instability with or without concomitant sphincteric incompetence (N = 35). Bladder training reduced the number of incontinent episodes by 57%; the effect was similar for both urodynamic diagnostic groups. The quantity of fluid loss was reduced by 54%. This was greater for patients with detrusor instability than for those without it. Diurnal and nocturnal voluntary micturitions were also reduced. The effect on nocturnal micturition, however, was not observed in subjects with unstable detrusor function. It is recommended that bladder training be considered as an initial step in treatment of women with urinary incontinence. Provided prior comprehensive clinical evaluation is done, it can be prescribed without the need for urodynamic characterization.

Efficacy of bladder training in older women with urinary incontinence

Efficacy of bladder training in older women with urinary incontinence