Variations in implementation of bladder training for overactive bladder: an online international survey

J Obstet Gynaecol. 2020 Jul;40(5):684-687. doi: 10.1080/01443615.2019.1647526. Epub 2019 Aug 30.

Abstract

We distributed an online questionnaire to 365 health care professionals specialising in urogynaecology, using the International Urogynaecology Association (IUGA) and British Society of Urogynecolgoy (BSUG) directories to investigate how the bladder training (BT) is provided in their units. We assessed the techniques provided, who provides them, and how these techniques are implemented and taught to the patients. Two hundred and thirteen (59%) completed responses have been received. 88% of the respondents felt that BT is an important and effective tool in treating overactive bladder. 50.7% indicated those physiotherapists are the health care practitioners responsible to deliver BT in their units. 88.3% of respondents use face-to-face consultation to deliver BT, 11% only use leaflets sent to patients. 87% use bladder diaries before implementing their BT. 26.4% use anti-muscarinic medications with BT from the start.IMPACT STATEMENTWhat is already known on this subject? Bladder training (BT) is a well-established behavioural therapy used to treat overactive bladder with comparable efficacy to pharmacotherapy with less side effects. It I recommended to be offered as first line therapy for at least 6 weeks. However, there is no clarity about the techniques and the methods used to deliver it.What do the results of the study add? The current study aimed to find out how the BT programme delivered to patients using an online questionnaire directed to a mixed group of medical urogynecology practitioners in different geographical regions. It showed that there is a wide variation in how the BT is delivered and lack of consistency in the techniques used and the duration recommended.What are the implications of these findings for clinical practice and/or further research? Future well-designed research is needed to look at the best ways to give BT instructions, the frequency of supervision of patients who use BT, the appropriate time length of the BT programme, and the best strategies to control urgency.

Keywords: Bladder training; behavioural therapy; overactive bladder; survey; urgency.

MeSH terms

  • Cognitive Behavioral Therapy / methods*
  • Combined Modality Therapy
  • Global Health
  • Gynecology / methods
  • Humans
  • Surveys and Questionnaires
  • Urinary Bladder, Overactive / psychology
  • Urinary Bladder, Overactive / therapy*
  • Urology / methods