A type of exercise called pelvic floor muscle training is effective for treating adult women with urinary incontinence, which affects up to 75 percent of older women in nursing homes, according to a new report from the Agency for Healthcare Research and Quality (AHRQ).
The report, published in Annals of Internal Medicine, also found that drug-based treatments can be effective, but the degree of benefit is low and side effects are common.
The cost of incontinence care in the United States averaged $19.5 billion in 2004, and by one estimate the annualized cost of women's nursing home admissions due to urinary incontinence was $3 billion, according to AHRQ.
Six percent of nursing home admissions of older women are attributable to urinary incontinence, AHRQ noted.
Researchers concentrated on two kinds of incontinence: stress incontinence, or the inability to retain urine during coughing or sneezing; and urgency incontinence, which is an involuntary loss of urine associated with the sensation of a compelling urge to urinate.
Exercises to strengthen the pelvic floor muscles, similar to Kegel exercises, were found to be effective in increasing women's ability to hold their urine. Pelvic floor muscle training combined with bladder training improved mixed (stress and urgency) incontinence, the AHRQ report found.
Estrogen treatment was found to be effective in treating stress incontinence, but with some side effects. Another drug treatment, the antidepressant duloxetine, was not found to be effective, while carrying high risk of side effects, AHRQ reported.
The report provides information about side effects with each drug to help clinicians and patients choose treatments with the most benefits.
Researchers said that while there is much evidence on clinical measures for treatment of urinary incontinence, there are fewer measures of quality of life related to the condition and its treatments.