Cochrane review measured the effects of bladder training compared to no treatment or anticholinergics in overactive bladder. Only one very small trial compared bladder training to no treatment and suggested improvement in incontinence symptoms. Furthermore, bladder training combined with anticholinergics vs anticholinergics alone suggested little to no difference in incontinence symptoms. In this analysis, bladder training had little to no impact on health-related quality of life (i.e. total symptoms) (SMD 0.07, 95 % CI -0.09 to 0.22, 2 trials, 630 patients). Self-reported cure/improvement rate suggested similar impact. About 10 % of patients in this analysis were men, which may slightly affect the results. Other analyses had very small sample sizes (under 30 patients).
Analyses comparing bladder training to anticholinergics suggested a similar impact between the treatments. Cure or improvement rate was higher for bladder training, however in at least one of the four trials bladder training included also pelvic muscle training.
| Reference | Study type | Population | Exposure and comparison | Outcomes | Risk of bias |
|---|---|---|---|---|---|
| BT= bladder training; AE=anticholinergic; NT=No treatment; PFME=pelvic floor muscle exercises; BF= biofeedback; ES=electrostimulation | |||||
| «Funada S, Yoshioka T, Luo Y, et al. Bladder traini...»1 | SR/MA | Adults >18 years Female 1700 Male 307 |
BT/NT BT/AE BT/PFMT BT/BT+AE/AE |
Self-reported cure Number of Incontinence episodes Number of urgency Number of micturiton QoL Adverse events |
High |
| Reference | Comments |
|---|---|
| «Funada S, Yoshioka T, Luo Y, et al. Bladder traini...»1 | Of the participants in the review about 90% were women. Men were included in one study regarding the analysis of anticholinergics + bladder training vs anticholinergics alone. The adverse events of the treatment were related to medicinal therapies (AE). |
Results
| Reference | Number of studies and number of patients (E/C) | Follow-up time | Mean (sd) I | Mean (sd) C | Mean Difference (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: very low The quality of evidence is downgraded due to study limitations and imprecision. BT=bladder training; AE=anticholinergic; NT=no treatment |
|||||
| «Funada S, Yoshioka T, Luo Y, et al. Bladder traini...»1 | 1 study, 14 patients BT vs no intervention |
6 weeks | -1,86 (-3.47, -0.25) | ||
| «Funada S, Yoshioka T, Luo Y, et al. Bladder traini...»1 | 1 study, 28 patients BT + AE vs AE |
12-24 weeks | 0.50 (0.02,0.98) | ||
| «Funada S, Yoshioka T, Luo Y, et al. Bladder traini...»1 | 2 studies 117 patients BT vs AE |
0.36 (-0.27, 1.00) | |||
| Reference | Number of studies and number of patients (E/C | Follow-up time | Baseline n | Follow-up n | Std. Mean Difference (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: very low The quality of evidence is downgraded due to study limitations and imprecision. BT=bladder training; AE=anticholinergic; NT=no treatment |
|||||
| «Funada S, Yoshioka T, Luo Y, et al. Bladder traini...»1 | 2 studies, 630 patients BT + AE vs AE |
12-16 weeks | 0.07 (-0.09, 0.22) | ||
| «Funada S, Yoshioka T, Luo Y, et al. Bladder traini...»1 | 2 studies, 117 patients BT vs AE |
-0.06 (-0.89, 0.77) | |||