Bladder Training—3 Years On

Holmes, David M.; Stone, Anthony R.; Bary, P. R.; Richards, C. J.; Stephenson, T. P.

doi:10.1111/j.1464-410x.1983.tb03399.x

Cited by 67 publications

(26 citation statements)

References 13 publications

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“…It is sometimes erroneously reduced to the combination of fluid restriction and timed voiding, but actually is a far richer therapy. Holmes et al reported the durability of behavioral therapy to control leakage in overactive bladder patients with initial response rates of 85% and 3-year response rates of 48% [65]. Burgio et al [66] compared their version of behavioral therapy with anticholinergic medication (oxybutynin chloride in titrated doses) in a group of patients with urge and mixed incontinence.…”

Section: Behavior Therapy and Oabmentioning

confidence: 99%

Pathophysiology of overactive bladder

2012

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Overactive bladder (OAB) is a common disorder that negatively affects the quality of life of our patients and carries a large socioeconomic burden. According to the International Continence Society, it is characterized as urinary urgency, with or without urge incontinence, usually, with frequency and nocturia in the absence of causative infection. The pathophysiology of this disease entity varies between neurogenic, myogenic, or idiopathic factors. This paper provides a review of the contemporary theories behind the pathophysiology of OAB.

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Section: Behavior Therapy and Oabmentioning

confidence: 99%

Pathophysiology of overactive bladder

2012

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“…Most have been based on subjective outcome, and only two have addressed very long-term follow-up after 4 and 6 years; both of these reported much higher success rates than has been our experience [5,11]. Others, however, have reported success rates similar to our own, for example 88% initially reducing to 38% after 6 months [12], and 85% initially reducing to about 50% at 3 years [13]. Although bladder retraining would appear to have limited success (32% of those who replied between 12 and 29 months later) in providing a satisfactory outcome for patients with sensory urgency or detrusor instability, it compares favorably with other treatments for the condition.…”

Section: Discussionmentioning

confidence: 79%

“…One study [6] was in agreement with our observation that there appeared to be no difference in response between those with sensory urgency and those with detrusory instability. Others, however, have suggested that those with stable bladders (sensory urgency) showed the most improvement [8,13,16], with either a poor response [8] or a tendency to relapse [13] in those with detrusor contractions. It is suggested that frequency without instability progresses to reduced compliance and thence to uninhibited contractions [8].…”

Section: Discussionmentioning

confidence: 99%

An Evaluation of the Efficacy of In-Patient Bladder Retraining

et al. 2000

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This is a retrospective review of 50 consecutive patients with urinary frequency, urgency and urge incontinence, admitted in 1995 and early 1996 for bladder retraining in the form of timed voiding. At discharge 80% of the women were subjectively cured or satisfactorily improved, but this was significantly reduced to 32% of the 37 who replied to a postal survey between 12 and 29 months (mean interval 21.3 months) later. There were no significant associations between outcome and urodynamic diagnosis, reduced cystometric capacity, length of symptomatology, previous treatment or requirement for additional therapy, but this may have been in part due to small numbers. In conclusion, bladder retraining is a method of treatment for patients with both sensory urgency and detrusor instability which appears to be at least as successful as other modes of treatment for these conditions.

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“…This latter factor has been forgotten by many in their assessment of the treatment. Holmes et al [15] showed that an initial success rate of 85% at 3 months following treatment fell to 50% at 3 years, and on the basis of this suggested that it was perhaps not as good a treatment as was originally thought. We would disagree with this assessment for two reasons.…”

Section: Discussionmentioning

confidence: 95%

A randomized controlled trial of urodynamic investigations prior to conservative treatment of urinary incontinence in the female

et al. 1995

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Sixty patients complaining of frequency, urgency, nocturia, urge incontinence and stress incontinence were randomly allocated to either undergo conservative treatment by way of combined physiotherapy and bladder retraining as an inpatient without prior urodynamics, or to have urodynamic investigations and treatment tailored to the urodynamic diagnosis. The assessment period was 3 months and assessment was made pre-and posttreatment by urinary diary, pad testing and subjective questionnaire. There was a significant improvement posttreatment for each parameter studied, with the exception of pad testing. There was no significant difference between the two groups for any parameter. Two-thirds of patients were cured to the extent that they did not require further treatment, and again there was no difference between the two groups. We conclude that patients attending for the first time with an uncomplicated story of urinary incontinence can be effectively treated conservatively without prior urodynamics.

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Bladder Training—3 Years On

Cited by 67 publications

References 13 publications

Pathophysiology of overactive bladder

Pathophysiology of overactive bladder

An Evaluation of the Efficacy of In-Patient Bladder Retraining

A randomized controlled trial of urodynamic investigations prior to conservative treatment of urinary incontinence in the female

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