Short-term Effects of a Systematized Bladder Training Program for Idiopathic Overactive Bladder: A Prospective Study

Abstract

PurposeThis study was to investigate whether a systematized bladder training (BT) program is effective for patients with idiopathic overactive bladder (OAB).MethodsA prospective study was conducted on 105 patients with OAB from March 2009 to November 2011. We developed a 30 minutes BT program, which consisted of first, refraining from going to the bathroom after feeling an urge to void, second, in order to stop thinking about voiding, ceasing action and thought temporarily, and third, performing pelvic floor exercises 5 to 6 times. Before and after BT, the patients filled out voiding diaries as well as the following questionnaires; International Consultation on Incontinence Questionnaire for overactive bladder (ICIQ-OAB), International Prostate Symptom Score (IPSS), overactive bladder questionnaire (OAB-q), the short form 36-item health survey (SF-36) questionnaire, the work productivity and activity impairment questionnaire, and a patients' perception of treatment benefit (PPTB).ResultsA final analysis was performed from on 85 patients (38 male, 47 female) with idiopathic OAB. After the first BT, the results of the ICIQ-OAB showed improvement in frequency, nocturia, and urgency (P<0.05), and all domains of IPSS questionnaires showed significant improvement (P<0.05). Among the SF-36 domains, the role-physical domain showed significant improvement after the first BT, and the general health domain showed significant improvement after the second. The voiding diaries showed statistically significant changes in maximal voided volume after the first BT, and nocturia index and nocturnal polyuria index after the second BT. According to the PPTB questionnaire, the perceived usefulness of BT increased after each session, and almost all of the patients replied that BT improved their symptoms.ConclusionsOur results demonstrated that BT was effective in improving many OAB related symptoms and quality of life in patients with idiopathic OAB. More clinical application of BT could be implemented in the future.

Interventions do not enhance medication persistence and compliance in patients with overactive bladder: a 24 weeks, randomised, open-label, multi-center trial

“…Behavioural treatments improved individual symptoms by changing patient behaviour or patient environment . Several guidelines have offered behavioural therapies as first‐line therapy to all patients with OAB , because they are effective at reducing symptom levels and carry no risk . Anticholinergics are also one of the main treatment modalities in conjunction with behavioural therapy, although they are considered a second‐line therapy in most guidelines .…”

Impedance Ratio Method for Urine Conductivity-Invariant Estimation of Bladder Volume

“…Usually, the patients try to meet a specific individual micturition volume goal which can be increased from time to time during the training period. Studies have shown that behavioural training and bladder training both significantly improve OBS symptoms [1,2,3,4]. Today, bladder volume is roughly estimated on time basis from historical data from the patient's micturition diary.…”

“…OBS patients often develop depressions, social isolation, show a reduced quality of life and decreased general health status. Especially in the elderly, falls while rushing to the toilet are frequent incidents [2].…”

Effect of Combined Systematized Behavioral Modification Education Program With Desmopressin in Patients With Nocturia: A Prospective, Multicenter, Randomized, and Parallel Study

“…Nocturia is one of several storage symptoms and it is usually associated with an overactive bladder. Although behavioral modification therapy and medication are initial treatment options for patients with overactive bladders [ 5 , 10 ], behavioral modification therapy has not been widely used in routine clinical practice in patients with nocturia. While both desmopressin and behavioral therapy are effective in patients with NPU [ 7 , 11 , 12 ], there is little evidence that demonstrates the efficacy of a combination of these treatments.…”

“…Second, the mean number of nocturnal voids was low, which means that the additional effect of the SBMP would have been greater in patients with severe nocturia. Third, we did not perform a urodynamic study to differentiate the mixed type of NPU with detrusor overactivity [ 10 ]. Fourth, the starting dose of desmopressin was 0.2 mg in the present study, which might help to explain why combining desmopressin treatment with the SBMP did not show any significant additional beneficial effects.…”