What alternatives to drug-based treatments help older patients with urinary incontinence?

This article reviewed studies that looked at the benefits of alternative treatments for older patients with urinary incontinence. The results showed that exercise and behavioral therapy may improve symptoms for older women with incontinence.

Urinary incontinence, the involuntary leakage of urine, can affect patients’ quality of life. It is particularly common in people over the age of 80. While there are several drugs that can treat incontinence, these do not suit many older patients who are more likely to develop side effects. Alternative ways to improve symptoms of incontinence that do not use drug-based treatments are needed.

27 studies that looked at alternative ways to treat older patients with incontinence were analyzed. These trials looked at eight different alternative treatments. These were pelvic floor training exercises, bladder training, behavioral therapy, electrical stimulation, nerve stimulation, magnetic stimulation, reducing caffeine consumption and acupuncture.

Of the eight treatment types, only three significantly improved patients’ symptoms. Older women who completed pelvic floor training exercises in a group had fewer incontinence episodes by 1.07 per day than those that did not. This was particularly effective for stress incontinence.

Older women who completed behavioral therapy 0.74 fewer incontinence episodes per day than those that did not. Bladder training was also associated with 0.77 fewer incontinence episodes per day, however, the quality of these studies was poor. The other alternative treatments did not significantly improve patients’ symptoms.

The authors concluded that pelvic floor training exercises and behavioral therapy may help older female patients with urinary incontinence.  

This study was limited by its use of data from medical records, which means that not all information was available. The study was also limited by different trial setups in different studies, which makes it difficult to draw strong conclusions.