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Urinary Incontinence in the Elderly: Bladder-Sphincter Biofeedback and Toileting Skills Training

KATHRYN LARSEN BURGIO, Ph.D.; WILLIAM E. WHITEHEAD, Ph.D.; and BERNARD T. ENGEL, Ph.D.
[+] Article and Author Information

Grant support: in part by Research Career Development Award MH00133 from the National Institute of Mental Health to Dr. Whitehead.

▸Requests for reprints should be addressed to Kathryn Larsen Burgio, Ph.D.; Gerontology Research Center, Francis Scott Key Medical Center, 4940 Eastern Avenue; Baltimore, MD 21224.


Bethesda and Baltimore, Maryland


Ann Intern Med. 1985;103(4):507-515. doi:10.7326/0003-4819-103-4-507
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Behavioral treatment of urinary incontinence was given to 39 elderly outpatients; 19 had stress incontinence, 12 detrusor motor instability, and 8 urge incontinence without instability. Biofeedback involving the bladder and sphincter was used to teach selective control of sphincter muscles or voluntary inhibition of detrusor contractions. Traditional behavioral methods used included habit training to gradually increase the voiding interval and relaxation training to cope with the urge to void. After an average 3.5 training sessions, patients with stress incontinence reduced the frequency of incontinent episodes an average of 82% (range, 55% to 100%). Patients with detrusor motor instability showed an average 85% improvement (range, 39% to 100%), and patients with urge incontinence reduced incontinence an average of 94% (range, 83% to 100%). Furthermore, 13 of the patients achieved total continence, and 19 had fewer than one accident per week after treatment.

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