Behavioral and pelvic floor muscle training program improves nocturia in women after menopause

This study compared the effects of behavioral and pelvic floor muscle training (B-PFMT) at home in women with nocturia and other urinary symptoms after menopause. Researchers suggested that B-PFMT programs are a good treatment option for these patients.

Urinary symptoms such as nocturia (waking up at night to urinate), urgency, and frequency are common among women. They are more common in aging women, particularly after menopause.

B-PFMT programs target problems with bladder storage. B-PFMT programs consist of behavioral training including bladder training to stop urgency. Pelvic muscle exercises and knack exercises are also part of the program. Knack exercises consist of contracting the pelvic muscles before an event associated with urine leakage.

Prior studies showed that supervised B-PFMT improves the treatment of nocturia and urinary urgency. Despite its positive effects, supervised B-PFMT programs limit the number of participants. Moreover, it might not be available in all countries. Therefore, it is important to evaluate whether unsupervised B-PFMT programs in women with urinary symptoms are similarly effective.

This study included information about 642 women with urinary symptoms after menopause. Initially, each patient was randomly assigned to an education session. This was either a face-to-face class for 2 hours (330; group 1) or a 20-minute video with the necessary information (312; group 2). After this, participants were told to continue the program in their homes following their educational guidelines.

The main outcomes were the change in urinary symptoms before and after treatment. The follow-up was at the start of the trial and then at 3, 12, and 24 months.

Patients from group 1 had significantly fewer nocturia episodes and longer void intervals at each follow-up. This group also had fewer urgency episodes at 12 months. Patients in group 2 had significantly fewer episodes of nocturia and urinary urgency. Group 2 also had a longer void interval at each follow-up.

No significant difference was observed between both groups. However, group 2 had better nocturia outcomes at 24 months. 

This study concluded that unsupervised B-PFMT programs improve nocturia and urinary symptoms in women after menopause.

This study was based on a trial that did not specifically recruit participants with nocturia, urinary urgency, and frequency. This might affect the results. Further studies are necessary with more specific populations.