MINNEAPOLIS, February 19, 2008—A University of Minnesota study has found that many urinary incontinence (UI) management techniques, including drugs and mechanical devices, are ineffective.

Reviewers found 96 randomized, controlled trials and three systematic reviews published in English from 1990 through May 2007. Reviewers abstracted cases of incontinence, improvement of urinary incontinence, and prevalence of urinary incontinence to calculate risk difference. 

The anticholinergic drugs oxybutynin and tolterodine resolved or improved UI compared with placebo, but many other drugs and mechanical devices used to control the condition showed little positive effects, and in some cases, negative ones.

“Buried in the bad news of widespread use of many products that don’t work is some very good news,” said Robert L. Kane, M.D., a University of Minnesota School of Public Health professor and an author of the review.

“The data show that intensive lifestyle changes, like losing weight through diet and exercise, would avoid 54 cases of stress urinary incontinence per 1,000 treated women, but it is unlikely women would stick with such a regimen just to avoid incontinence," Kane said.

A better response to UI may be pelvic floor muscle training, also known as kegeling. This training can correct an underlying cause of urinary incontinence: the weakened pelvic floor muscles that can occur after childbirth or in overweight people.

In the studies, pelvic floor muscle training alone often resolved or improved urinary incontinence compared with regular or ordinary care.

Kane said, "Pelvic floor muscle training, or kegeling, resolved 490 cases of stress urinary incontinence, and 80 cases of any urinary incontinence, and 167 cases of stress or urge urinary incontinence per 1,000 treated women.”

The review, “Systematic Review: Randomized, Controlled Trials of Nonsurgical Treatments for Urinary Incontinence in Women,” appears at Annals of Internal Medicine, and will be published in the March 18 print edition of the journal.