Pelvic floor muscle training is effective for treating adult women with urinary incontinence (UI) without risk of side effects, according to a new report from the Agency for Healthcare Research and Quality (AHRQ). The report also found that drug-based treatments can be effective, but the degree of benefit is low and side effects are common.
In response to a request from the public, AHRQ funded a systematic review of the clinical research to determine what is known about the comparative effectiveness, benefits, and adverse effects of UI interventions for women and the utility of methods for diagnosis and treatment evaluation. The systematic review included 905 publications presenting the results of clinical studies published from January 1990 through December 2011.
Researchers concentrated on 2 types of incontinence—stress incontinence and urgency incontinence. Exercises to strengthen the pelvic floor muscles were found to be effective in increasing women's ability to hold their urine. Pelvic floor muscle training combined with bladder training improved mixed (stress and urgency) incontinence, the report found. Estrogen treatment was found to be effective in treating stress incontinence, but with some side effects. Another drug treatment, the antidepressant duloxetine, was not found to be effective, while carrying high risk of side effects.
Overall, the report found that the drugs reviewed showed similar effectiveness. However, with some drugs, more women discontinued treatment due to bothersome side effects.
The full report is available from AHRQ. A summary is provided to clinicians to inform discussions of options with patients and to assist in decision making along with consideration of a patient's values and preferences.