Link between symptom severity and success of conservative therapy for urinary incontinence in women

This article investigated the link between symptom severity (SS) and the success of conservative management (CM) in women with urinary incontinence (UI). The authors concluded that mild SS was associated with improved CM success.  

Overactive active bladder (OAB) is a condition where there is a frequent feeling of needing to urinate. Stress urinary incontinence (SUI) is needing to urinate when pressure is placed on the bladder (running, jumping, sneezing). Mixed urinary incontinence (MUI) is a mix of both of these. OAB, SUI, and MUI are recommended to be first treated with CM (bladder exercises). 

It is not known whether the severity of these symptoms affects the success of the CM. 

The study involved 140 female patients. 50 patients had OAB, 50 had MUI and 40 had SUI. All patients completed 3-6 months of CM. Questionnaires were used to evaluate patients' symptoms.

In the OAB groups, 30 patients had successful treatment (group 1) and 20 had failed treatment (group 2). Group 1 had lower OAB SS scores (30) compare to group 2 (80).  Group 1 had fewer urgency episodes (a sudden need to urinate) compared to group 2 (4 vs 6). Group 1 also had fewer episodes of UI (5.5 vs 15) than in group 2. Patients in group 1 had a higher quality of life (QOL) compared to group 2. 

In the MUI group, 21 patients had successful treatment (group 3) and 29 had failed treatment (group 4). Group 3 had less UE (3 vs 6) than in group 4. Group 3 had fewer episodes of UI (11 vs 15) than in group 4.  

In the SUI group, 21 patients had successful treatment (group 5) and 19 had failed treatment (group 6). Group 5 had less UE (1 vs 2) than in group 6. Group 5 had fewer episodes of UI (11 vs 13.5) compared to group 4.  

Patients with OAB who had treatment success were 1.10 times more likely to have improved QOL. Patients with MUI with treatment success were 26% less likely to suffer from urgency episodes and 17% less likely to suffer from UI episodes. Patients with SUI with CM success were 43% less likely to have UI episodes. The milder the SS the more successful the CM outcome. 

The authors concluded that mild SS was associated with improved CM success.  

This study involved a small sample size so a larger study would be required to confirm the results.