Objective: The purpose of our study was to see the efficacy of 3 different modes of treatment for overactive bladder (OAB) in symptoms reduction and quality of life improvement. Methods: We conducted a 12-week single-blinded randomized controlled trial of women aged 22–65 years with clinical diagnosis of OAB. Arm A (n = 47) received bladder training, arm B (n = 50) received pelvic floor muscle training (PFMT), and arm C (n = 50) received PFMT with biofeedback. Bladder diary was used to assess the difference in urinary frequency, urgency, and leak accidents before and after treatment. Initial and final assessment was made using -validated urogenital distress inventory short form 6 (UDI-SF6) and incontinence impact questionnaire short form 7 (IIQ-SF7). Results: UDI-SF6 scores showed significant improvement in all arms. There was a reduction in UDI-6 scores from 8.38 ± 4.3 to 4.77 ± 5.5 with a mean difference of 3.61 ± 7.4 in patients in arm A (p = 0.002), arm B (p = 0.01), and arm C (p = 0.016). All patients in arms A, B, and C reported significant improvement in quality of life as assessed by IIQ-SF7 scores with significant p values of 0.009, 0.051, and 0.001, respectively. Bladder diary results using paired t test showed the significant difference in day time urinary frequency in arm A after treatment, as well as the reduction in both leak accidents and urgency score in all 3 arms. Conclusions: All 3 arms of study showed significant results and can be used as the first line of management.

1.
Haylen BT, Freeman RM, Swift SE, Cosson M, Davila GW, Deprest J, Dwyer PL, Fatton B, Kocjancic E, Lee J, Maher C, et al: An -International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) and grafts in female pelvic floor surgery. Neurourol Urodyn 2011; 30: 2–12.
2.
Stewart W, Van Rooyen JB, Cundiff GW, Abrams P, Herzog AR, Corey R, Hunt TL, wein AJ: Prevalence and burden of overactive bladder in the United States. World J Urol 2003; 20: 327–336.
3.
Coyne KS, Sexton CC, Thompson CL, Milsom I, Irwin D, Kopp ZS, Chapple CR, Kaplan S, Tubaro A, Aiyer LP, Wein AJ: The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study. BJU Int 2009; 104: 352–360.
4.
Milsom I, Kaplan SA, Coyne KS, Sexton CC, Kopp ZS: Effect of bothersome overactive bladder symptoms on health-related quality of life, anxiety, depression, and treatment seeking in the United States: results from EpiLUTS. Urology 2012; 80: 90–96.
5.
Kaya S, Akbayrak T, Beksaç S: Comparison of different treatment protocols in the treatment of idiopathic detrusor overactivity: a randomized controlled trial. Clin Rehabil 2011; 25: 327–338.
6.
Burgio KL, Locher JL, Goode PS: Combined behavioral and drug therapy for urge incontinence in older women. J Am Geriatr Soc 2000; 48: 370–374.
7.
Berghmans LC, Van Waalwijk van Doorn ES, Nieman FH, De Bie RA, Smeets LW, ten Haaf H, van Kerrebroeck P: Efficacy of extramural physical therapy modalities in women with proven bladder overactivity: a randomized clinical trial. Neurourol Urodyn 2000; 19: 92.
8.
Dumoulin C, Hay-Smith EJ, Mac Habée-Séguin G: Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev 2014; 14:CD005654.
9.
Hartmann KE, McPheeters ML, Biller DH, et al: Treatment of overactive bladder in women. Evid Rep Technol Assess (Full Rep) 2009; 187: 1–120.
10.
Gormley EA, Lightner DJ, Burgio KL, Chai TC, Clemens JQ, Culkin DJ, Das AK, Foster HE Jr, Scarpero HM, Tessier CD, Vasavada SP: Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. J Urol 2012; 188: 2455–2463.
11.
Dumoulin C, Hunter KF, Moore K, Bradley CS, Burgio KL, Hagen S, Imamura M, Thakar R, Williams K, Chambers T: Conservative management for female urinary incontinence and pelvic organ prolapse review 2013: summary of the 5th International Consultation on Incontinence. Neurourol Urodyn 2016; 35: 15–20.
12.
Arruda RM, Castro RA, Sousa GC: Prospective randomized comparison of oxybutynin, functional electrostimulation, and pelvic floor training for treatment of detrusor overactivity in women. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19: 1055–1061.
13.
Colombo M, Zanetta G, Scalambrino S: Oxybutynin and bladder training in the management of female urinary urge incontinence: a randomized study. Int Urogynecol J 1995; 6: 63–67.
14.
Burgio KL, Goode PS, Johnson TM, Hammontree L, Ouslander JG, Markland AD, Colli J, Vaughan CP, Redden DT: Behavioral versus drug treatment for overactive bladder in men: the Male Overactive Bladder Treatment in Veterans (MOTIVE) Trial. J Am Geriatr Soc 2011; 59: 2209–2216.
15.
Subak LL, Wing R, West DS: Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med 2009; 360: 481–490.
16.
Burgio KL, Locher JL, Goode PS, Hardin JM, McDowell BJ, Dombrowski M, Candib D: Behavioral vs drug treatment for urge urinary incontinence in older women: a randomized controlled trial. JAMA 1998; 280: 1995–2000.
17.
Goode PS, Burgio KL, Locher JL, et al: Urodynamic changes associated with behavioral and drug treatment of urge incontinence in older women. J Am Geriatr Soc 2002; 50: 808–816.
18.
Song C, Park JT, Heo KO, et al: Effects of bladder training and/or tolterodine in female patients with overactive bladder syndrome: a prospective, randomized study. J Korean Med Sci 2006;21:1060–1063.
19.
Kafri R, Langer R, Dvir Z, et al: Rehabilitation vs drug therapy for urge urinary incontinence: short-term outcome. Int Urogynecol J Pelvic Floor Dysfunct 2007; 18: 407–411.
20.
Johnson TM, Burgio KL, Redden DT, Wright KC, Goode PS: Effects of behavioral and drug therapy on nocturia in older incontinent women. J Am Geriatr Soc 2005; 53: 846–850.
21.
Johnson TM, Markland AD, Goode PS, Vaughan CP, Colli JL, Ouslander JG, Redden DT, McGwin G, Burgio KL: Efficacy of adding behavioural treatment or antimuscarinic drug therapy to α-blocker therapy in men with nocturia. BJU Int 2013; 112: 100–108.
22.
Burgio KL: Update on behavioral and -physical therapies for incontinence and overactive bladder: the role of pelvic floor muscle training. Curr Urol Rep 2013; 14: 457–464.
23.
Laycock J, Jerwood D: Pelvic floor muscle assessment: the PERFECT scheme. Physiotherapy 2001; 87: 631–642.
24.
Montori VM, Guyatt GH: Intention-to-treat principle. CMAJ 2001; 165: 1339–1341.
25.
Lee HE, Seung-June Oh: The effectiveness of bladder training in overactive bladder. Curr Bladder Dysfunct Rep 2014; 9: 63–70.
26.
Kaya S, Akbayrak T, Gursen C, Beksac S: Short-term effect of adding pelvic floor muscle training to bladder training for female urinary incontinence: a randomized controlled trial. Int Urogynecol J 2015; 26: 285–293.
27.
Azuri J, Kafri R, Ziv-Baran T, Stav K: Outcomes of different protocols of pelvic floor physical therapy and anti-cholinergics in women with wet over-active bladder: a 4-year follow-up. Neurourol Urodyn 2017; 36: 755–758.
28.
Wallace SA., Roe B, Williams K, Palmer M: Bladder training for urinary incontinence in adults. Cochrane Database Syst Rev 2004; 1: CD001308.
29.
Wang AC, Wang YY, Chen MC: Single-blind, randomized trial of pelvic floor muscle training, biofeedback-assisted pelvic floor muscle training, and electrical stimulation in the management of overactive bladder. Urology 2004; 63: 61–66.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.