Bladder training (BT), the maintenance of a scheduled voiding regime at gradually adjusted intervals, is a common treatment for overactive bladder (OAB).
To assess the effects of isolated BT and/or in combination with other therapies on OAB symptoms.
A systematic review of eight databases was conducted. After screening titles and abstracts, full texts were retrieved. Cochrane RoB 2 and the GRADE approach were used.
Fourteen RCTs were included: they studied isolated BT (n = 11), BT plus drug treatment (DT; n = 5), BT plus intravaginal electrical stimulation (IVES; n = 2), BT plus biofeedback and IVES (n = 1), BT plus pelvic floor muscle training and behavioral therapy (n = 2), BT plus percutaneous tibial nerve stimulation, and BT plus transcutaneous tibial nerve stimulation (n = 1). In a meta-analysis of short-term follow-up data, BT plus IVES resulted in greater improvement in nocturia (mean difference [MD]: 0.89, 95% CI: 0.5, 1.20), urinary incontinence (UI; MD: 1.93, 95% CI: 1.32, 2.55), and quality of life (QoL; MD: 4.87, 95% CI: 2.24, 7.50) than isolated BT, while DT and BT improved UI (MD: 0.58, 95% CI: 0.23, 0.92) more than isolated BT.
In the short term, BT plus IVES improves the OAB symptoms of nocturia and UI while improving QoL. The limited number of RCTs and heterogeneity among them provide a low level of evidence, making the effect of BT on OAB inconclusive, which suggests that new RCTs should be performed.
Brazilian journal of physical therapy. 2024 Jul 29 [Epub ahead of print]
A K Rocha, S Monteiro, I Campos, M Volpato, D Verleun, L Valim, C Riccetto, S Botelho
Postgraduate Program in Rehabilitation Sciences, Institute of Motricity Sciences, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil., Department of Physiotherapy at Pontifícia Universidade Católica de Minas Gerais (PUC-MINAS), Belo Horizonte, Minas Gerais, Brazil; Postgraduate Program in Surgical Sciences, School of Medicine of the Universidade Estadual de Campinas, (UNICAMP), Campinas, São Paulo, Brazil., Postgraduate Program in Surgical Sciences, School of Medicine of the Universidade Estadual de Campinas, (UNICAMP), Campinas, São Paulo, Brazil., Latu Sensu Postgraduate Program in Physiotherapy in Women's Health and Pelvic Dysfunctions - Faculdade de Ciências Médicas de Minas Gerais (FCMMG), Belo Horizonte, Minas Gerais, Brazil., Department of Physiotherapy at Pontifícia Universidade Católica de Minas Gerais (PUC-MINAS), Belo Horizonte, Minas Gerais, Brazil., Postgraduate Program in Rehabilitation Sciences, Institute of Motricity Sciences, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil; Postgraduate Program in Surgical Sciences, School of Medicine of the Universidade Estadual de Campinas, (UNICAMP), Campinas, São Paulo, Brazil. Electronic address: .