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Activity Faculty

Andrew Sokol, MD
Georgetown University School of Medicine
Washington, DC

Article Summary

Burgio KL, Locher JL, Goode PS, et al. Behavioral vs drug treatment for urge urinary incontinence in older women: a randomized controlled trial. JAMA. 1998;280:1995-2000.


Urgency incontinence is a common condition that has an impact on patients' daily activities and quality of life. Anticholinergic therapy is often prescribed; however, medication can be expensive, side effects can be bothersome, and rates of treatment discontinuation are consistently high. This study compares behavioral therapy with biofeedback to anticholinergic medications and placebo for the treatment of urgency and urge-predominant mixed urinary incontinence.


197 women ages 55-92 years with urgency or urge-predominant mixed urinary incontinence were randomized to 4 sessions (8 weeks) of biofeedback-assisted behavioral treatment, oxybutynin chloride (2.5 mg daily–5 mg 3 times daily), or a placebo control condition.


Expert Opinion

This study was the first randomized clinical trial of biofeedback-assisted behavioral therapy for the treatment of urgency incontinence. While subsequent studies have shown that the addition of biofeedback or electrical stimulation to pelvic floor muscle physical therapy (PFMT) does not improve its effectiveness, strong evidence supports the effectiveness of PFMT for urgency and mixed urinary incontinence, and it is considered the first-line treatment for these bothersome conditions.

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