Bladder training combined with other conservative therapies may be superior to bladder training alone for improving patient-reported symptoms in women with idiopathic overactive bladder.

Author(s): K. Megson & C. Carus - Pages: 36–46

Abstract

Overactive bladder (OAB) symptoms can have a significant effect on quality of life, including participation in physical and social activities of daily living. A conservative therapy is defined as any intervention that does not involve surgery or pharmacology, and is internationally accepted as the first-line treatment for OAB. It is acknowledged that conservative therapies have a relatively low cost and minimal adverse events. Second-line treatment involves antimuscarinic drug therapy, but side effects such as dry mouth, headaches and constipation are common. Current guidance recommends that conservative strategies such as bladder training (BT) are combined with pharmacological therapy for the optimal management of OAB (Lightner et al. 2019). However, the efficacy of combining BT with other conservative therapies (e.g. pelvic floor muscle training, electromyographic biofeedback, electrical stimulation, and percutaneous and transcutaneous tibial nerve stimulation) remains uncertain. The focus of this literature review was to evaluate the existing evidence for the efficacy of BT combined with other forms of conservative treatment in comparison to BT alone on patient-reported symptoms in women with idiopathic OAB. A literature search covering the period from 2011 to 2021 was performed, and three relevant randomized controlled trials were identified. The findings suggest that BT combined with another conservative treatment is superior to BT alone for improving patient-reported symptoms of OAB. However, further research of high methodological quality is required to investigate the most clinically and cost-effective combination of conservative treatments.

Keywords: bladder training, conservative therapy, overactive bladder, physiotherapy.