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Internet-based treatment of stress urinary incontinence: a randomised controlled study with focus on pelvic floor muscle training.


ABSTRACT: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Stress urinary incontinence (SUI) affects 10-35% of women, and it is sometimes very distressful. Pelvic floor exercises are the first line of treatment, but access barriers or embarrassment may prevent women from seeking help. There is a need for new, simple, and effective ways to deliver treatment. Management of SUI without face-to-face contact is possible, and Internet-based treatment is a new, promising treatment alternative.To compare two treatment programmes for stress urinary incontinence (SUI) without face-to-face contact: one Internet-based and one sent by post.Randomised, controlled trial conducted in Sweden 2009-2011. Computer-generated block-randomisation, allocation by independent administrator. No 'blinding'. The study included 250 community-dwelling women aged 18-70 years, with SUI ?1?time/week. Consecutive online recruitment. The women had 3 months of either; (i) An Internet-based treatment programme (124 women), including e-mail support and cognitive behavioural therapy assignments or (ii) A treatment programme sent by post (126). Both programmes focused mainly on pelvic floor muscle training.symptom-score (International Consultation on Incontinence Questionnaire Short Form, ICIQ-UI SF) and condition-specific quality of life (ICIQ-Lower Urinary Tract Symptoms Quality of Life, ICIQ-LUTSQoL).(i) Patient Global Impression of Improvement, (ii) Incontinence aids, (iii) Patient satisfaction, (iv) Health-specific QoL (EQ5D-Visual Analogue Scale), and (v) Incontinence episode frequency. Follow-up after 4 months via self-assessed postal questionnaires.In all, 12% (30 women) were lost to follow-up. Intention-to-treat analysis showed highly significant improvements (P?0.8) with both interventions, but there were no significant differences between groups in primary outcomes. The mean (sd) changes in symptom-score were: Internet 3.4?(3.4), Postal 2.9?(3.1) (P?=?0.27). The mean (sd) changes in condition-specific QoL were: Internet 4.8?(6.1), Postal 4.6?(6.7) (P?=?0.52). Compared with the postal-group, more participants in the Internet-group perceived they were much or very much improved (40.9% (43/105) vs 26.5% (30/113), P?=?0.01), reported reduced usage of incontinence aids (59.5% (47/79) vs 41.4% (34/82), P?=?0.02) and were satisfied with the treatment programme (84.8% (89/105) vs 62.9% (71/113), P?50%.Concerning primary outcomes, treatment effects were similar between groups whereas for secondary outcomes the Internet-based treatment was more effective. Internet-based treatment for SUI is a new, promising treatment alternative.

SUBMITTER: Sjostrom M 

PROVIDER: S-EPMC3798106 | biostudies-literature | 2013 Aug

REPOSITORIES: biostudies-literature

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Internet-based treatment of stress urinary incontinence: a randomised controlled study with focus on pelvic floor muscle training.

Sjöström Malin M   Umefjord Göran G   Stenlund Hans H   Carlbring Per P   Andersson Gerhard G   Samuelsson Eva E  

BJU international 20130125 3


<h4>Unlabelled</h4>WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Stress urinary incontinence (SUI) affects 10-35% of women, and it is sometimes very distressful. Pelvic floor exercises are the first line of treatment, but access barriers or embarrassment may prevent women from seeking help. There is a need for new, simple, and effective ways to deliver treatment. Management of SUI without face-to-face contact is possible, and Internet-based treatment is a new, promising treatment al  ...[more]

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