The men were randomly assigned to one of three groups. One group participated in eight weeks of behavioral therapy, another group had behavioral therapy plus biofeedback and pelvic floor electrical stimulation and the third group was given no additional treatment and served as the control group. The men were asked to keep bladder diaries throughout the study.
Behavioral therapy, which included four home visits, about one every two weeks, involved instruction in pelvic floor exercises, pelvic muscle contraction and daily exercises, such as deliberately stopping the flow of urine. they also practiced urge control, which meant delaying a visit to the toilet and using pelvic floor contractions to avoid an accident. Men in this group were instructed to drink eight ounces of beverages six to eight times a day, spaced throughout the day. They were advised to avoid caffeine.
The second group received this training and, in addition, was given in-office biofeedback training and daily at-home pelvic floor electrical stimulation, according to the study.
After eight weeks, the researchers found that the average number of incontinence episodes dropped from 28 to 13 a week, a 55 percent decline, for the men in the behavioral therapy group, and from 26 to 12 episodes a week, down 51 percent, for men who'd had biofeedback and electrical stimulation as well as behavioral therapy. The control group had a 24 percent reduction, on average, in incontinence episodes.
The reductions in incontinence lasted at least 12 months, the study found.
"We were very pleased," Goode said. "And, the men who decreased their accidents by half were thrilled."
Not everyone is convinced, however, that behavioral therapy is the best option.
"For patients with incontinence, especially bad incontinence, behavioral therapy might not be worth the time," said Dr. David Penson, professor of urological surgery and dire
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