Urinary incontinence of rural older women dramatically improved by behavioral ...( g twice the prevalence of UI as men. T...),Health

g twice the prevalence of UI as men. The condition, often incorrectly thought to be a consequence of aging, is embarrassing, and many women choose not to discuss it with a healthcare professional. In addition to being uncomfortable, UI can be a symptom of other medical conditions, such as infection, nerve damage from diabetes or other illnesses.

The behavioral management intervention involved the women setting goals for their continence, followed by up to three behavioral phases in sequence. The intervention could take as long as 6 months if the women participated in all phases, but most women achieved their goals in one or two phases. Most began with bladder training, which involved emptying the bladder at regular timed intervals, gradually increasing the intervals until they were able to space them to every 2 hours or more. Other women, however, began with the self-monitoring phase, which lasted for 4 weeks. They were selected for this phase based on such factors as drinking two or more cups of caffeinated beverages, urinating two or more times during the night, or urinating during the day at intervals longer than 4 hours apart. The women kept a bladder diary that included such information as descriptions of their liquid intake and intervals between urination. Based on the results, they were coached to reduce! caffeine consumption and adjust fluid amount and timing of drinking, in order to decrease or increase urination intervals.

If women did not attain their goals in the first two phases, they moved on to the pelvic muscle (kegel) exercises with biofeedback phase. This intervention, which strengthens the muscles to prevent leaking urine, lasted up to 12 weeks. Sensors were placed on the skin over the pelvic muscles and attached to a notebook computer. Signals would appear on the screen that reflected the voluntary contractions of the pelvic muscles and allowed the women to monitor the effectiveness of their exercises.

Dr.
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Contact: Linda Cook
lc59t@nih.gov
301-496-0209
NIH/National Institute of Nursing Research
31-Jan-2002

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