This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (161)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

J. Andrew Fantl, MD; Jean F. Wyman, PhD, RN; Donna K. McClish, PhD; Stephen W. Harkins, PhD; Ronald K. Elswick, PhD; John R. Taylor, MD; Evan C. Hadley, MD

JAMA. 1991;265(5):609-613.

Abstract
The efficacy of bladder training was evaluated in a randomized clinical trial involving 123 noninstitutionalized women 55 years and older with urinary incontinence. Subjects were urodynamically categorized as those with urethral sphincteric incompetence (N = 88) and those with detrusor instability with or without concomitant sphincteric incompetence (N = 35). Bladder training reduced the number of incontinent episodes by 57%; the effect was similar for both urodynamic diagnostic groups. The quantity of fluid loss was reduced by 54%. This was greater for patients with detrusor instability than for those without it. Diurnal and nocturnal voluntary micturitions were also reduced. The effect on nocturnal micturition, however, was not observed in subjects with unstable detrusor function. It is recommended that bladder training be considered as an initial step in treatment of women with urinary incontinence. Provided prior comprehensive clinical evaluation is done, it can be prescribed without the need for urodynamic characterization.

(JAMA. 1991;265:609-613)

Author Affiliations
From the Departments of Obstetrics and Gynecology (Dr Fantl), Community and Psychiatric Nursing (Dr Wyman), Biostatistics (Drs McClish and Elswick), Gerontology (Dr Harkins), and Neurology (Dr Taylor), Virginia Commonwealth University/Medical College of Virginia, Richmond; and the Geriatrics Program, National Institute on Aging, Bethesda, Md (Dr Hadley).

Footnotes
Reprint requests to Continence Program for Women, Department of Obstetrics and Gynecology, Box 34, MCV Station, Richmond, VA 23298 (Dr Fantl).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Systematic Review: Randomized, Controlled Trials of Nonsurgical Treatments for Urinary Incontinence in Women
Shamliyan et al.
ANN INTERN MED 2008;148:459-473.
ABSTRACT | FULL TEXT  

NICE guidelines on urinary incontinence in women
Woodford and George
Age Ageing 2007;36:349-350.
FULL TEXT  

Management of Overactive Bladder
Ouslander
NEJM 2004;350:786-799.
FULL TEXT  

Behavioral Training With and Without Biofeedback in the Treatment of Urge Incontinence in Older Women: A Randomized Controlled Trial
Burgio et al.
JAMA 2002;288:2293-2299.
ABSTRACT | FULL TEXT  

Interventions led by nurse continence advisers in the management of urinary incontinence: a randomized controlled trial
Borrie et al.
CMAJ 2002;166:1267-1273.
ABSTRACT | FULL TEXT  

Quality Indicators for the Management of Urinary Incontinence in Vulnerable Community-Dwelling Elders
Schnelle and Smith
ANN INTERN MED 2001;135:752-758.
FULL TEXT  

Reliability Assessment of the Bladder Diary for Urinary Incontinence in Older Women
Locher et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2001;56:32M-35.
ABSTRACT | FULL TEXT  

Psychological Improvements Associated With Behavioral and Drug Treatment of Urge Incontinence in Older Women
Burgio et al.
Journals of Gerontology Series B: Psychological Sciences and Social Science 2001;56:46P-51.
ABSTRACT | FULL TEXT  

Outcomes of a Small Group Educational Intervention for Urinary Incontinence: Episodes of Incontinence and Other Urinary Symptoms
Mcfall et al.
J Aging Health 2000;12:250-267.
ABSTRACT  

Behavioral vs Drug Treatment for Urge Urinary Incontinence in Older Women: A Randomized Controlled Trial
Burgio et al.
JAMA 1998;280:1995-2000.
ABSTRACT | FULL TEXT  

An 89-Year-Old Woman With Urinary Incontinence
Resnick
JAMA 1996;276:1832-1840.
ABSTRACT  

Treatment of urinary incontinence in women in general practice: observational study
Seim et al.
BMJ 1996;312:1459-1462.
ABSTRACT | FULL TEXT  

Predictors of Successful Prompted Voiding Among Incontinent Nursing Home Residents
Ouslander et al.
JAMA 1995;273:1366-1370.
ABSTRACT  

Older Women's Health: Avoiding a Tragedy of Mythic Proportions
Cohen and Cahan
Arch Fam Med 1993;2:361-363.
ABSTRACT  

Geriatric Medicine
Prestwood and Besdine
JAMA 1992;268:360-362.
ABSTRACT  

BLADDER TRAINING CAN OVERCOME INCONTINENCE
JWatch General 1991;1991:2-2.
FULL TEXT