Cognitive behavioral therapy for overactive bladder in women: study protocol for a randomized controlled trial

Abstract

Background Overactive bladder (OAB) symptoms affect daily life by decreasing health-related quality of life (HRQol). However, there remain no very effective treatment for OAB. Pharmacotherapy is one of the best treatments, but it is not always efficient and may incur adverse events. Although behavioral therapy is another effective treatment, there are very few structured treatment manuals on how to prescribe behavioral therapy to treat OAB for whom. Cognitive behavioral therapy (CBT) is a psychotherapy consisting of structured sessions to solve problems with the collaborative empiricism between therapists and patients. OAB symptoms are supposed to worsen with cognitive distortion, and CBT is expected to be effective in treating OAB by modifying such cognitive processes. In this trial, we will evaluate the efficacy of CBT for OAB. Methods A randomized, controlled, open-label, multicenter parallel-group superiority trial will be conducted. Participants with moderate to severe OAB symptoms with or without pharmacotherapy will be recruited and will be randomly allocated 1:1 to two different groups by minimization (age, baseline OAB severity, treatment status, types of intervention, and treating institutions). The intervention group will be prescribed an individual CBT program covering six techniques in 4 sessions (30 min each), with or without pharmacotherapy. The primary outcome is the change scores in an OAB-questionnaire (OAB-q) from baseline to the end of the trial (week 13). Secondary outcomes will include other patient reported outcome measures and the frequency volume chart. All analyses will be conducted on an intention-to-treat principle. Discussion This trial will determine the efficacy of CBT to treat OAB using a rigorous methodology. The effectiveness of CBT with a structured manual may not only lead to a new treatment option for patients suffering from OAB symptoms, but may also reduce the social burden by OAB. Trial registration UMIN-CTR Clinical Trial, CTR-UMIN000038513 . Registered on November 7, 2019.

Relationships Between Urinary and Nonurinary Symptoms in Treatment-Seeking Women in LURN

“…The current results complement this prior work through investigation of these associations in a large clinical population and support calls for multidisciplinary assessments of patients seeking care for LUTS to improve treatment outcomes 9 . The integration of multidisciplinary treatment, such as cognitive behavioral therapy, is being studied 23,24 and provides great promise for treatment of LUTS based on results from other chronic conditions, such as irritable bowel syndrome 25 …”

“…8 The current results complement this prior work through investigation n ORIGINAL RESEARCH Longitudinal Urinary Symptoms in Women of these associations in a large clinical and calls for multidisciplinary assessments of patients seeking care for LUTS to improve treatment outcomes. 9 The integration of multidisciplinary treatment, such as cognitive behavioral therapy, is being studied 23,24 and provides great promise for treatment of LUTS based on results from other chronic conditions, such as irritable bowel syndrome. 25 Potential mechanistic relationships between each of the nonurologic factors studied here (mental health symptoms, sleep, and physical function) and various LUTS are not yet known but are plausible, strengthening the importance of ongoing research in this area.…”

Proposal for a Clinical Protocol for the Conservative Treatment of Urge Urinary Incontinence

“…It is worth remembering that this treatment guided by exercises for the training of the PFM is considered as a first line in the treatment of overactive bladder, as is cognitive-behavioral therapy. PFM training is considered the gold standard for the treatment of UUI, showing a high level of scientific evidence, however patient compliance to training protocols represents the greatest threat to the success of therapy 14 .…”

Proposta De Protocolo Clínico Para Tratamento Conservador Da Incontinência Urinária De Urgência

“…É válido lembrar que esse tratamento guiado pelos exercícios para o treinamento da MAP é tido como primeira linha no tratamento da bexiga hiperativa, assim como a terapia cognitivo-comportamental. O treinamento da MAP é considerado padrão-ouro para o tratamento da IUU, mostrando um alto nível de evidências científicas, no entanto a adesão do paciente aos protocolos de treinamento representa a maior ameaça ao sucesso da terapia 14 .…”