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Kathryn L Burgio

Publications and source records attributed to Kathryn L Burgio.

At least 19 recordsLinked to original sources
PubMed2006

Global ratings of patient satisfaction and perceptions of improvement with treatment for urinary incontinence: validation of three global patient ratings.

AIMS: To test the validity of three patient global ratings, satisfaction, perception of improvement, and estimated percent improvement, for measuring outcomes of behavioral treatment for urinary incontinence. METHODS: This report is a secondary analysis of data from three randomized controlled trials testing behavioral interventions for incontinence. Participants were 359 community-dwelling women, aged 40-92 years, with stress, urge, or mixed urinary incontinence. All participants received an 8-week program of clinic-based or self-administered behavioral training. Subjective outcomes included a patient satisfaction question (PSQ), global perception of improvement (GPI), and estimated percent improvement (EPI). Convergent validity was tested by examining the relationship between each measure and reduction of incontinence (bladder diary), change on the incontinence impact questionnaire (IIQ), and desire for another treatment. Discriminant validity was explored by examining the relationship of the global ratings to five measures not expected to be related to outcome (age, race, BMI, education level, and change in perceived pain). RESULTS: All three patient global ratings were significantly associated with each other (P < 0.0001), with diary measures of reduction of incontinence episodes (P < 0.0001), and change in the IIQ (P < 0.005), and inversely associated with desire for another treatment (P < 0.0001). All three patient ratings were not significantly associated with age, race, BMI, education level, or change in perceived pain. CONCLUSION: Patient global ratings of satisfaction, perception of improvement, and estimated percent improvement have acceptable convergent and discriminant validity for measuring outcomes in studies of behavioral treatment for urinary incontinence.

Adult↗
PubMed2006

Outcomes with porcine graft placement in the anterior vaginal compartment in patients who undergo high vaginal uterosacral suspension and cystocele repair.

OBJECTIVE: The purpose of this study was to prospectively assess the cases of patients who had undergone a high uterosacral suspension and anterior repair with anterior compartment placement of porcine dermis graft. STUDY DESIGN: Thirty-six patients who underwent transvaginal high uterosacral suspension and cystocele repair with graft augmentation from June 2001 to July 2004 were identified from the University of Alabama at Birmingham Genitourinary Disorders database. Analysis included the pre- and postoperative Pelvic Organ Prolapse Quantification examinations and incontinence impact questionnaire-7/urogenital distress inventory-6. RESULTS: Mean Pelvic Organ Prolapse Quantification Ba improved from +3.3 +/- 2.2 cm to -0.6 +/- 1.7 cm (P < .01). Postoperative Ba was prolapse stage II or greater in 50% of subjects. Mean incontinence impact questionnaire-7 scores improved from 36.2 +/- 31.9 to 15.6 +/- 26.2 (P < .01), as did mean urogenital distress inventory-6 scores from 58.2 +/- 26.8 to 23.8 +/- 22.6 (P < .01). CONCLUSION: Significant improvements in Pelvic Organ Prolapse Quantification measures, urinary symptoms, and the impact of incontinence were seen after the operation. However, a significant proportion of patients had Pelvic Organ Prolapse Quantification stage II prolapse or greater, which made it unclear whether graft use confers a significant advantage.

Aged↗
PubMed2006

Preoperative biofeedback assisted behavioral training to decrease post-prostatectomy incontinence: a randomized, controlled trial.

PURPOSE: We tested the effectiveness of preoperative biofeedback assisted behavioral training for decreasing the duration and severity of incontinence, and improving quality of life in the 6 months following radical prostatectomy. MATERIALS AND METHODS: We performed a prospective, randomized, controlled trial comparing preoperative behavioral training to usual care. The volunteer sample included 125 men 53 to 68 years old who elected radical prostatectomy for prostate cancer. Patients were stratified according to age and tumor differentiation, and randomized to 1 preoperative session of biofeedback assisted behavioral training plus daily home exercise or a usual care control condition, consisting of simple postoperative instructions to interrupt the urinary stream. The main outcome measurements were duration of incontinence (time to continence), as derived from bladder diaries, incontinence severity (the proportion with severe/continual leakage), pad use, Incontinence Impact Questionnaire, psychological distress (Hopkins Symptom Checklist) and health related quality of life (Medical Outcomes Study Short Form Health Survey). RESULTS: Preoperative behavioral training significantly decreased time to continence (p = 0.03) and the proportion of patients with severe/continual leakage at the 6-month end point (5.9% vs 19.6%, p = 0.04). There were also significant differences between the groups for self-reported urine loss with coughing (22.0% vs 51.1%, p = 0.003), sneezing (26.0% vs 48.9%, p = 0.02) and getting up from lying down (14.0% vs 31.9%, p = 0.04). No differences were found on return to work and usual activities or quality of life measures. CONCLUSIONS: Preoperative behavioral training can hasten the recovery of urine control and decrease the severity of incontinence following radical prostatectomy.

Aged↗
PubMed2006

Interest in research participation among hospice patients, caregivers, and ambulatory senior citizens: practical barriers or ethical constraints?

OBJECTIVES: The purpose of this survey study was to explore hypothetical interest in research participation among hospice patients and caregivers compared to ambulatory senior citizens. DESIGN: Cross-sectional survey. SETTING: Twenty-one community-based hospice offices, a university medical center geriatric ambulatory care clinic, and 3 community-based senior citizen centers. PARTICIPANTS: Participants were hospice patients, caregivers, and ambulatory senior citizens not enrolled in hospice. MEASUREMENTS: Using a self-administered questionnaire, participants rated their interest in participating in survey/interview and therapeutic studies, identified potential benefits and barriers to research participation, and reported their preferences for who they would want to approach them about research participation. RESULTS: Forty-six percent of hospice patients and 60% of caregivers reported an interest in interview or survey research participation; 45% and 57%, respectively, expressed interest in therapeutic research. Compared to hospice patients, caregivers reported higher rates of personal interest in both survey research (p =< 0.001) and therapeutic research (p=<0.001) and were more likely to report that the hospice patients they cared for would be interested (p = 0.005 and p = 0.027). Younger hospice patients were more favorably disposed toward both survey and therapeutic research participation than hospice patients over the age of 75 (p = 0.063 and 0.011). The proportion of older hospice patients showing interest in research did not differ significantly from ambulatory senior citizens for either type of research (p = 0.56, 0.98). CONCLUSION: This study suggests that many hospice patients are interested in research participation and are able to articulate benefits and barriers, which supports the inclusion of this population in research.

Aged↗
PubMed2006

Risk factors for anal sphincter tear in multiparas.

OBJECTIVE: To assess maternal, newborn, and obstetric risk factors associated with anal sphincter tear in multiparous women. METHODS: This case-control study identified 18,779 multiparous vaginal deliveries from 1992 to 2004 from an obstetric automated record database at the University of Alabama at Birmingham. Two hundred eighty-four patients were selected, 145 cases and 139 controls. Variables from the index pregnancy and prior pregnancies were analyzed, and multivariable logistic regression models were constructed to determine significant predictor variables for anal sphincter tear in multiparous women. RESULTS: One hundred forty-five multiparous women with no history of cesarean delivery sustained a sphincter tear. Multivariable logistic regression showed a significant association with episiotomy (odds ratio [OR] 16.3, 95% confidence interval [CI] 7.7-34.4), shoulder dystocia (OR 7.9, CI 1.6-38), forceps delivery (OR 4.7, CI 2.0-11.2), and being married (OR 2.2, CI 1.1-4.6). A second exploratory model that included variables from previous pregnancies, showed that in addition to episiotomy (OR 34.6, CI 8.8-136), shoulder dystocia (OR 11.1, CI 1.3-95.2), forceps delivery (OR 6.1, CI 1.6-23.5), previous sphincter tear (OR 7.7, CI 1.2-48.7), and second stage of labor greater than 1 hour (OR 6.7, CI 1.1-42.5) were associated with tear. CONCLUSION: The strongest clinical risk factors for anal sphincter tear in multiparous women are episiotomy, shoulder dystocia, previous sphincter tear, prolonged second stage of labor, and forceps delivery. LEVEL OF EVIDENCE: II-2.

Adult↗
PubMed2006

Fecal and urinary incontinence in primiparous women.

OBJECTIVE: To prospectively investigate the relationship between anal sphincter tears and postpartum fecal and urinary incontinence. METHODS: The Childbirth and Pelvic Symptoms study was a prospective cohort study performed by the Pelvic Floor Disorders Network to estimate the prevalence of postpartum fecal and urinary incontinence in primiparous women: 407 with clinically recognized anal sphincter tears during vaginal delivery, 390 without recognized sphincter tears (vaginal controls), and 124 delivered by cesarean before labor. Women were recruited postpartum while hospitalized and interviewed by telephone 6 weeks and 6 months postpartum. We assessed fecal and urinary incontinence symptoms using the Fecal Incontinence Severity Index and the Medical, Epidemiological, and Social Aspects of Aging Questionnaire, respectively. Odds ratios were adjusted for age, race, and clinical site. RESULTS: Compared with the vaginal control group, women in the sphincter tear cohort reported more fecal incontinence (6 weeks, 26.6% versus 11.2%; adjusted odds ratio [AOR] 2.8, 95% confidence interval [CI] 1.8-4.3; 6 months, 17.0% versus 8.2%; AOR 1.9, 95% CI 1.2-3.2), more fecal urgency and flatal incontinence, and greater fecal incontinence severity at both times. Urinary incontinence prevalence did not differ between the sphincter tear and vaginal control groups. Six months postpartum, 22.9% of women delivered by cesarean reported urinary incontinence, whereas 7.6% reported fecal incontinence. CONCLUSION: Women with clinically recognized anal sphincter tears are more than twice as likely to report postpartum fecal incontinence than women without sphincter tears. Cesarean delivery before labor is not entirely protective against pelvic floor disorders. LEVEL OF EVIDENCE: II-3.

Adult↗
PubMed2005

Regret, satisfaction, and symptom improvement: analysis of the impact of partial colpocleisis for the management of severe pelvic organ prolapse.

OBJECTIVE: The purpose of this study was to assess a cohort of patients who underwent a colpocleisis procedure more than 1 year post operation to determine: 1) the proportion of patients who regretted having the procedure, 2) patient satisfaction with the procedure, and 3) changes in symptom severity after surgery. STUDY DESIGN: Using the University of Alabama at Birmingham (UAB) Genitourinary Disorders Center database, a prospective analysis was performed on 54 patients who underwent colpocleisis between August 1996 and April 2003. From August to October of 2004, participants were contacted by an investigator not involved with the surgery and were asked 1) "do you regret having your surgery, and, if so, why?," 2) "how satisfied are you with your progress (completely, somewhat, or not)?," and 3) to repeat the short form Incontinence Impact Questionnaire/Urogenital Distress Inventory (IIQ-7/UDI-6). RESULTS: Fifty-nine percent (32/54) of potential candidates participated in the study. Nine percent (3/32) of patients regretted having colpocleisis performed. Fifty-seven percent (16/28) were completely satisfied, 29% (8/28) somewhat satisfied, and 14% (4/28) not satisfied. Mean IIQ score improved significantly from 40.9 (+/-31.7) at baseline to 14.1 (+/-26.7) at last interview (P = .003). Mean UDI score improved significantly from 63.1 (+/-24.3) at baseline to 24.2 (+/-26.7) at last interview (P = .001). There was a negative correlation between change in UDI scores with time since procedure (r = -.397, P = .055) and age (r = -.435, P = .034). CONCLUSION: Few patients reported regret after partial colpocleisis. There was a high rate of patient satisfaction and significant symptom improvement more than a year post surgery. Stable but smaller improvements were reported with longer time from surgery and increasing age.

Aged↗
PubMed2005

Factors associated with incontinence frequency in a surgical cohort of stress incontinent women.

OBJECTIVE: The aim of this study was to identify factors associated with urinary incontinence severity at baseline in women undergoing surgery for stress incontinence. STUDY DESIGN: Baseline data were obtained from 650 women (age 28 to 81 years) with stress incontinence participating in a randomized surgical trial. Severity of incontinence was defined by the mean number of incontinence episodes per day recorded in a 3-day bladder diary. The relationships between severity and several baseline variables were examined, including demographics, medical, obstetric, and gynecologic history, body mass index, smoking status, Q-tip displacement, and Pelvic Organ Prolapse Quantification stage (POP-Q). RESULTS: In a multivariable model, severity of incontinence was positively associated with body mass index (P = .0003) and current smoking (P = .01), and negatively associated with prolapse stage (P < .0001) and Q-tip displacement (P = .042). CONCLUSION: Incontinence severity in a surgical population was independently associated with 2 modifiable factors, obesity and tobacco use, as well as pelvic support.

Adult↗
PubMed2005

The effect of the presence of others on caloric intake in homebound older adults.

BACKGROUND: Undernutrition in homebound older adults is a significant problem. The purpose of this study was to investigate the effect of the presence of others, both within the household and during meals, on caloric intake in homebound older adults. METHODS: In-depth interviews and three 24-hour dietary recalls were obtained from 50 older adults who were receiving home health services. Descriptive statistics were used to characterize participants, and hierarchical linear modeling was performed to evaluate predictors of caloric intake per meal. RESULTS: Participants' mean age was 77. Females composed 65% and African Americans composed 42% of the sample. Analyses are based on 553 meal observations. The majority (84%) of participants consumed all meals for each of the 3 days of data collection; however, they consumed an average of only 1305 calories per day. Hierarchical linear modeling analysis indicated that persons who had others present during meals consumed an average of 114.0 calories more per meal than those who ate alone (p =.009) and that women consumed 76.7 fewer calories per meal than did men (p =.045). The presence of others within the household had no effect on caloric intake. CONCLUSION: This research suggests that a simple and inexpensive way to increase caloric intake in homebound older adults is to make arrangements for family members or caregivers to eat with them.

Aged↗
PubMed2005

Urinary and anal incontinence in morbidly obese women considering weight loss surgery.

OBJECTIVE: To estimate prevalence and correlates of urinary and anal incontinence in morbidly obese women undergoing evaluation for laparoscopic weight loss surgery. METHODS: From October 2003 to February 2005, 180 women with body mass index (BMI) of 40 or greater underwent evaluation for laparoscopic weight loss surgery. Using an established Web site, questionnaires were completed to assess symptoms of urinary incontinence, including the Medical, Epidemiological, and Social Aspects of Aging Questionnaire (MESA). Anal incontinence was assessed by asking, "Do you have any uncontrolled anal leakage?" A number of clinical and demographic variables were examined as potential risk factors for urinary incontinence and anal incontinence. RESULTS: Mean age was 39.8 years (range 16-55). Body mass index ranged from 40 to 81 (mean 49.5). Prevalence of urinary incontinence was 66.9% and anal incontinence was 32.0% (45.6% loss of gas only, 21.1% liquid stool only, 24.6% gas and liquid stool only, 8.8% solid stool). In simple logistic regression, presence of urinary incontinence was associated with age (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.01-1.09), number of children (OR 1.54, 95% CI 1.15-2.07), anal incontinence (OR 6.34, 95% CI 2.52-15.93), arthritis (OR 6.04, 95% CI 1.76-20.78), and sleep apnea (OR 2.30, 95% CI 1.21-4.37). Multivariable logistic regression identified 3 factors independently associated with urinary incontinence: number of children (OR 1.55, 95% CI 1.12-2.12), arthritis (OR 5.46, 95% CI 1.51-19.73), and anal incontinence (OR 6.27, 95% CI 2.42-16.26). Presence of anal incontinence was associated only with the presence of urinary incontinence (OR 6.34, 95% CI 2.52-15.93). CONCLUSION: Prevalence of urinary and anal incontinence is high in this group of morbidly obese women as compared with the general population. Studies are needed to determine the effect of weight loss on urinary and anal incontinence symptoms in the morbidly obese woman.

Adolescent↗
PubMed2005

Stress urinary incontinence in active elderly women.

Urinary incontinence in the elderly is a significant health problem fraught with isolation, depression, and an increased risk of institutionalization and medical complications. Stress urinary incontinence (SUI), the complaint of involuntary loss of urine during effort or exertion or during sneezing or coughing, is the most common type of urinary incontinence. SUI can seriously degrade the quality of life for many active seniors, and has become an economic challenge for society. With the rapid increase in the active elderly worldwide, SUI is becoming a significant global problem. However, since only a fraction of women with SUI have consulted a physician, the clinical extent and public health impact of SUI are probably underestimated. The mounting social, medical, and economic problem of SUI in active elderly women as a rapidly growing segment of the population worldwide is reviewed. We evaluate the age-related changes of the lower urinary tract, examine risk factors, and suggest different treatment options shown to be effective in reducing SUI in this population.

Female↗
PubMed2005

Prevalence and correlates of fecal incontinence in community-dwelling older adults.

OBJECTIVES: To determine prevalence and correlates of fecal incontinence in older community-dwelling adults. DESIGN: A cross-sectional, population-based survey. SETTING: Participants interviewed at home in three rural and two urban counties in Alabama from 1999 to 2001. PARTICIPANTS: The University of Alabama at Birmingham Study of Aging enlisted 1,000 participants from the state Medicare beneficiary lists. The sample was selected to include 25% black men, 25% white men, 25% black women, and 25% white women. MEASUREMENTS: The survey included sociodemographic information, medical conditions, health behaviors, life-space assessment (mobility), and self-reported health status. Fecal incontinence was defined as an affirmative response to the question "In the past year, have you had any loss of control of your bowels, even a small amount that stained the underwear?" Severity was classified as mild if reported less than once a month and moderate to severe if reported once a month or greater. RESULTS: The prevalence of fecal incontinence in the sample was 12.0% (12.4% in men, 11.6% in women; P=.33). Mean age+/-standard deviation was 75.3+/-6.7 and ranged from 65 to 106. In a forward stepwise logistic regression analysis, the following factors were significantly associated with the presence of fecal incontinence in women: chronic diarrhea (odds ratio (OR)=4.55, 95% confidence interval (CI)=2.03-10.20), urinary incontinence (OR=2.65, 95% CI=1.34-5.25), hysterectomy with ovary removal (OR=1.93, 95% CI=1.06-3.54), poor self-perceived health status (OR=1.88, 95% CI=1.01-3.50), and higher Charlson comorbidity score (OR=1.29, 95% CI=1.07-1.55). The following factors were significantly associated with fecal incontinence in men: chronic diarrhea (OR=6.08, 95% CI=2.29-16.16), swelling in the feet and legs (OR=3.49, 95% CI=1.80-6.76), transient ischemic attack/ministroke (OR=3.11, 95% CI=1.30-7.41), Geriatric Depression Scale score greater than 5 (OR=2.83, 95% CI=1.27-6.28), living alone (OR=2.38, 95% CI=1.23-4.62), prostate disease (OR=2.29, 95% CI=1.04-5.02), and poor self-perceived health (OR=2.18, 95% CI=1.13-4.20). The following were found to be associated with increased frequency of fecal incontinence in women: chronic diarrhea (OR=6.39, 95% CI=2.25-18.14), poor self-perceived health (OR=5.37, 95% CI=1.75-16.55), and urinary incontinence (OR=4.96, 95% CI=1.41-17.43). In men, chronic diarrhea (OR=5.38, 95% CI=1.77-16.30), poor self-perceived health (OR=3.91, 95% CI=1.39-11.02), lower extremity swelling (OR=2.86, 95% CI=1.20-6.81), and decreased assisted life-space mobility (OR=0.73, 95% CI=0.49-0.80) were associated with more frequent fecal incontinence. CONCLUSION: In community-dwelling older adults, fecal incontinence is a common condition associated with chronic diarrhea, multiple health problems, and poor self-perceived health. Fecal incontinence should be included in the review of systems for older patients.

Black or African American↗
PubMed2005

Effects of behavioral and drug therapy on nocturia in older incontinent women.

OBJECTIVES: To examine changes in nocturia from a multicomponent behavioral training program or drug therapy in older women with urge or mixed (urge-predominant) urinary incontinence. DESIGN: A secondary analysis of data from a prospective, randomized clinical trial. SETTING: Parent trial was an outpatient research protocol in Alabama. PARTICIPANTS: One hundred ninety-seven women (aged 55-92) with incontinence and urodynamic evidence of bladder dysfunction. At baseline, 131 women (66% of participants) had nocturia. INTERVENTION: In the parent study, participants received behavioral training, including four sessions of biofeedback-assisted pelvic floor muscle exercises, drug treatment (oxybutynin IR titrated from 2.5 mg per day to 5.0 mg three times a day), or placebo. MEASUREMENTS: Participant-completed bladder diaries were used to calculate changes in nocturia. RESULTS: Behavioral training reduced nocturia by a median 0.50 episodes per night and was significantly more effective than drug treatment (median reduction=0.30 episodes; P=.02) and placebo (median reduction=0.00 episodes; P<.001). Also, drug treatment was more effective than control (P=.007). CONCLUSION: Both behavioral training and drug treatment reduced nocturia more than placebo, but behavioral training was the most effective.

Aged↗
PubMed2004

Tension-free vaginal tape: a prospective subjective and objective outcome analysis.

The purpose of this prospective study was to describe the effects of the tension-free vaginal tape (TVT) procedure on subjective and objective outcomes. Eighty-seven women (aged 31-95 years) underwent a TVT procedure and were followed for up to 24 months using the Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory (UDI-6), and a Patient Satisfaction Questionnaire. IIQ-7 scores improved from a mean 51.1 before surgery to 12.7 at 1 month (p<0.001) indicating reduced impact of incontinence on quality of life. UDI-6 scores declined from a mean 61.8 to 21.9 (p<0.001) indicating improvement in urinary symptoms. At 1 month, 91.2% of patients were satisfied. Improvements on all measures were maintained throughout follow-up. Urodynamic evaluation of 57 patients (mean: 15.0 months) showed that 91.2% had a negative stress test. Results indicate significant immediate and sustained improvement in incontinence impact and urinary symptoms, and a high rate of patient satisfaction and objective cure.

Adult↗
PubMed2004

Obstructive sleep apnea, nocturia and polyuria in older adults.

STUDY OBJECTIVE: The purpose of this study was to examine the relationship between nocturia and obstructive sleep apnea (OSA) in community dwelling older men and women. DESIGN: A repeated measures design was employed over a 24-hour period. SETTING: The study was conducted in a clinical research center. PARTICIPANTS: Thirty community-dwelling elders (mean age=65.5, SD=8.4 years) with symptoms of nocturia and sleep disordered breathing, volunteered to participate. Both men (n = 13) and women (n = 17) and minority subjects (African-Americans, n = 19; Caucasian, n = 11) were included in the study. INTERVENTIONS: NA. MEASUREMENTS: Blood specimens were collected every 4 hours, except for an 8-hour collection period overnight. Urine specimens were collected ad libitum and at the end of each data collection interval. Urine and blood specimens were analyzed for ANP and AVP content. Polysomnography was conducted using a full 18-channel montage. Apnea was defined as a decrease in airflow of > or = 90% for a minimum of 10 seconds. Hypopnea was defined as > or = 30% decrease in airflow and desaturations required a > or = 3% decrease in oxygen saturation for a minimum of 10 seconds. The apnea hypopnea index (AHI) was calculated as the sum of apneas and hypopneas divided by hours of sleep. RESULTS: Twenty of the thirty subjects were found to have clinically diagnosable OSA (AHI > or = 5). AVP excretion was not correlated with changes in AHI levels. Conversely, total urine output, plasma ANP and urine ANP excretion were significantly higher among subjects with higher AHI levels (> 15). CONCLUSION: In subjects with elevated AHI (> 15), nighttime urine production and ANP excretion are elevated.

Aged↗
PubMed2004

Behavioral treatment options for urinary incontinence.

Behavioral treatments improve bladder control by changing the incontinent patient's behavior, especially his or her voiding habits, and by teaching skills for preventing urine loss. These treatments are effective for most outpatient men and women with stress, urge, or mixed incontinence. The average reduction in the frequency of incontinence ranges from 57% to 86%. In long-term care settings, treatment is generally more challenging and yields more modest results. The advantages of behavioral interventions include the absence of side-effects, patient comfort, and high levels of patient satisfaction. Although most patients who receive behavioral treatment achieve significant improvement, most are not completely dry. Thus, there is a need for research to explore ways to enhance the effectiveness of these conservative therapies. Combining behavioral treatment with other treatments may have additive effects. Research is also needed to understand better the mechanisms of therapeutic change, the best methods for teaching pelvic floor muscle control, the optimal exercise regimens, the predictors of outcome, and the efficacy of behavioral treatments in men. Although behavioral interventions are more accepted today than 20 years ago, they are still not widely available or integrated into most clinical practices, and we know little of how effective they will be in these settings. Thus, it will be important to develop and evaluate creative modes of delivery, such as group intervention (especially by nonphysician providers), in a variety of clinical settings.

Behavior Therapy↗
PubMed2004

Current perspectives on management of urgency using bladder and behavioral training.

Behavioral interventions for overactive bladder (OAB) include bladder training and behavioral training. Bladder training focuses on modifying bladder function by changing voiding habits; a bladder diary is indispensable. Behavioral training focuses on improving voluntary control rather than bladder function. It works through modification of the bladder outlet using methods, such as pelvic floor muscle training and urge suppression strategies to inhibit detrusor (bladder) muscle contraction. Behavioral methods--with biofeedback (which requires instrumentation), verbal feedback during a pelvic examination (using vaginal or anal palpation), or electrical stimulation--appear to be at least as effective in terms of reducing incontinence episodes as currently available drug therapy. However, evidence suggests that combining behavioral and drug therapy may produce better results than either approach alone. More research is needed to elucidate the role of behavioral modification in reducing urgency, frequency, and nocturia.

Behavior Therapy↗