Bladder HealthResearchUrinary Incontinence

Interventions for Overactive Bladder: Review of Pelvic Floor Muscle Training and Urgency Control Strategies

Journal of Women’s Health Physical Therapy

Reisch, Rebecca PT, DPT, PhD

It is common practice to focus on education and behavioral retraining when treating patients to overcome urgency. While there are well-supported theoretical rationales for behavioral treatment, this review illuminates the state of the evidence for the use of behavior retraining techniques in practice. 

Overactive bladder (OAB) is a common condition with a negative impact on quality of life. Physical therapists utilize multiple treatments for OAB, including behavioral training such as pelvic floor muscle training and urgency control strategies.

The purposes of this narrative literature review were to describe the rationale and theory for behavioral training techniques for OAB, review published evidence for these techniques, and discuss additional questions provoked by the review as well as future research directions.

Pelvic floor muscle training for OAB has been studied by multiple authors. Most outcomes are favorable, but there is inadequate evidence to support any specific training protocol. Similarly, modalities to aid pelvic floor muscle training and/or reduce urinary urgency generally have positive results but published studies are difficult to compare and ideal treatment parameters are unclear. Cognitive strategies as a component of treatment for OAB, while commonly used clinically, are understudied at this time. Overall, while there is evidence to support behavioral training, the currently available literature on this subject leaves many unanswered questions.

Behavioral treatment for OAB is well supported by solid theoretical rationales, but evidence for the treatment is equivocal and leaves practitioners with many unanswered questions. Studies on the details of behavioral therapy for OAB are strongly needed.

Read the literature review to learn more.

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