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Obstetrics & Gynecology 2003;102:940-947
© 2003 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Predictors of Outcome in the Behavioral Treatment of Urinary Incontinence in Women

Kathryn L. Burgio, PhD, Patricia S. Goode, MD, Julie L. Locher, PhD, Holly E. Richter, PhD, MD, David L. Roth, PhD, Kate Clark Wright and R. Edward Varner, MD

From the Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center; and the School of Medicine, Center for Aging, and School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.

Address reprint requests to: Kathryn L. Burgio, PhD, Birmingham VA Medical Center, GRECC/11G, 700 19th Street South, Birmingham, AL 35233; E-mail: kburgio{at}aging.uab.edu.

OBJECTIVE: To identify predictors of outcome of a multi-component behavioral training program for urge and stress incontinence in women.

METHODS: This report is a secondary analysis of data from three prospective, randomized, clinical trials testing behavioral interventions for urinary incontinence. Participants were a volunteer sample of 258 ambulatory, nondemented, community-dwelling women, aged 40–92 years, with stress, urge, or mixed urinary incontinence. Participants received 8 weeks (four visits) of multicomponent behavioral training in each study. The relationship between a number of variables and treatment success were explored by univariate and multivariable logistic regression analyses.

RESULTS: Successful treatment of predominantly urge incontinence (75% reduction of incontinent episodes as recorded on bladder diary) was associated with not wearing any form of protection for incontinence (P = .045; 95% confidence interval [CI] .282, .987). Achieving total continence (100% reduction) was associated with fewer incontinent episodes at baseline (P < .001; 95% CI .138, .557), previous surgery for incontinence (P = .021; 95% CI 1.169, 6.543), and lower education level (P = .022; 95% CI .175, .871). Successful treatment of predominantly stress incontinence (75% reduction) was related to not having previous evaluation or treatment for incontinence (P = .001; 95% CI .026, .415), and fewer incontinent episodes on baseline bladder diary (P =.026; 95% CI .210, .907). Outcomes were not associated with age, race, type of incontinence, or a number of other variables reflecting medical history, obstetric history, medications, pelvic examination, body mass index, urodynamic parameters, or psychological distress.

CONCLUSION: Aside from indicators of severity and previous treatment, there were few associations between baseline clinical variables and outcome of behavioral treatment.






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