Effects of Behavioral and Drug Therapy on Nocturia in Older Incontinent Women

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Abstract
Objectives: To examine changes in nocturia from a multicomponent behavioral training program or drug therapy in older women with urge or mixed (urge‐predominant) urinary incontinence.Design: A secondary analysis of data from a prospective, randomized clinical trial.Setting: Parent trial was an outpatient research protocol in Alabama.Participants: One hundred ninety‐seven women (aged 55–92) with incontinence and urodynamic evidence of bladder dysfunction. At baseline, 131 women (66% of participants) had nocturia.Intervention: In the parent study, participants received behavioral training, including four sessions of biofeedback‐assisted pelvic floor muscle exercises, drug treatment (oxybutynin IR titrated from 2.5 mg per day to 5.0 mg three times a day), or placebo.Measurements: Participant‐completed bladder diaries were used to calculate changes in nocturia.Results: Behavioral training reduced nocturia by a median 0.50 episodes per night and was significantly more effective than drug treatment (median reduction=0.30 episodes; P=.02) and placebo (median reduction=0.00 episodes; P<.001). Also, drug treatment was more effective than control (P=.007).Conclusion: Both behavioral training and drug treatment reduced nocturia more than placebo, but behavioral training was the most effective.