Effect of Behavioral Training with or Without Pelvic Floor Electrical Stimulation on Stress Incontinence in Women

A Randomized Controlled Trial

Patricia S. Goode, Kathryn L. Burgio, Julie L. Locher, David L Roth, Mary G. Umlauf, Holly E. Richter, R. Edward Varner, L. Keith Lloyd

Research output: Contribution to journalArticle

Abstract

Context: Pelvic floor electrical stimulation (PFES) has been shown to be effective for stress incontinence. However, its role in a multicomponent behavioral training program has not been defined. Objective: To determine if PFES increases efficacy of behavioral training for community-dwelling women with stress incontinence. Design and Setting: Prospective randomized controlled trial conducted from October 1, 1995, through May 1, 2001, at a university-based outpatient continence clinic in the United States. Patients: Volunteer sample of 200 ambulatory, nondemented, community-dwelling women aged 40 to 78 years with stress or mixed incontinence with stress as the predominant pattern; stratified by race, type of incontinence (stress only vs mixed), and severity (frequency of episodes). Interventions: Patients were randomly assigned to 8 weeks (4 visits) of behavioral training, 8 weeks (4 visits) of the behavioral training plus home PFES, or 8 weeks of self-administered behavioral treatment using a self-help booklet (control condition). Main Outcome Measures: Primary outcome was percentage reduction in the number of incontinent episodes as documented in bladder diaries. Secondary outcomes were patient satisfaction and changes in quality of life. Results: Intention-to-treat analysis showed that incontinence was reduced a mean of 68. 6% with behavioral training, 71.9% with behavioral training plus PFES, and 52. 5% with the self-help booklet (P=.005). In comparison with the self-help booklet, behavioral training (P=.02) and behavioral training plus PFES (P=.002) were significantly more effective, but they were not significantly different from each other (P=.60). The PFES group had significantly better patient self-perception of outcome (P

Original languageEnglish (US)
Pages (from-to)345-352
Number of pages8
JournalJournal of the American Medical Association
Volume290
Issue number3
DOIs
StatePublished - Jul 16 2003
Externally publishedYes

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Pelvic Floor
Electric Stimulation
Randomized Controlled Trials
Pamphlets
Independent Living
Intention to Treat Analysis
Ambulatory Care Facilities
Patient Satisfaction
Self Concept
Volunteers
Urinary Bladder
Quality of Life
Outcome Assessment (Health Care)
Education

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effect of Behavioral Training with or Without Pelvic Floor Electrical Stimulation on Stress Incontinence in Women : A Randomized Controlled Trial. / Goode, Patricia S.; Burgio, Kathryn L.; Locher, Julie L.; Roth, David L; Umlauf, Mary G.; Richter, Holly E.; Varner, R. Edward; Lloyd, L. Keith.

In: Journal of the American Medical Association, Vol. 290, No. 3, 16.07.2003, p. 345-352.

Research output: Contribution to journalArticle

Goode, Patricia S. ; Burgio, Kathryn L. ; Locher, Julie L. ; Roth, David L ; Umlauf, Mary G. ; Richter, Holly E. ; Varner, R. Edward ; Lloyd, L. Keith. / Effect of Behavioral Training with or Without Pelvic Floor Electrical Stimulation on Stress Incontinence in Women : A Randomized Controlled Trial. In: Journal of the American Medical Association. 2003 ; Vol. 290, No. 3. pp. 345-352.
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