Effects of behavioral and drug therapy on nocturia in older incontinent women.

OBJECTIVES To examine changes in nocturia from a multicomponent behavioral training program or drug therapy in older women with urge or mixed (urge-predominant) urinary incontinence. DESIGN A secondary analysis of data from a prospective, randomized clinical trial. SETTING Parent trial was an outpatient research protocol in Alabama. PARTICIPANTS One hundred ninety-seven women (aged 55-92) with incontinence and urodynamic evidence of bladder dysfunction. At baseline, 131 women (66% of participants) had nocturia. INTERVENTION In the parent study, participants received behavioral training, including four sessions of biofeedback-assisted pelvic floor muscle exercises, drug treatment (oxybutynin IR titrated from 2.5 mg per day to 5.0 mg three times a day), or placebo. MEASUREMENTS Participant-completed bladder diaries were used to calculate changes in nocturia. RESULTS Behavioral training reduced nocturia by a median 0.50 episodes per night and was significantly more effective than drug treatment (median reduction=0.30 episodes; P=.02) and placebo (median reduction=0.00 episodes; P<.001). Also, drug treatment was more effective than control (P=.007). CONCLUSION Both behavioral training and drug treatment reduced nocturia more than placebo, but behavioral training was the most effective.