Bladder Training Supported by Alarm Reminders and Distraction Techniques for Mixed Urinary Incontinence

Izmir Katip Celebi University111 enrolled

Overview

This randomized controlled trial evaluated the effectiveness of bladder training supported by smartphone alarm reminders and distraction techniques in women with persistent mixed urinary incontinence who continued to experience symptoms despite completing pelvic floor muscle exercise (PFME) therapy at least six months previously. Participants were stratified according to age, educational level, body mass index, mode of delivery, and baseline urinary incontinence severity before randomization to either an intervention group or a control group. The intervention group received an 8-week bladder training program supported by alarm reminders and distraction techniques, while the control group received routine care. Outcomes included urinary incontinence severity, symptom distress, quality of life, urinary incontinence episodes, voiding intervals, treatment satisfaction, and adherence to bladder training.

Mixed urinary incontinence is a common condition that negatively affects women's physical, psychological, and social well-being. Although pelvic floor muscle exercise (PFME) is recommended as the first-line conservative treatment, many women continue to experience urinary incontinence despite completing therapy. Effective management strategies for women with persistent symptoms after PFME remain limited. The purpose of this randomized controlled trial was to evaluate whether bladder training supported by smartphone alarm reminders and distraction techniques improves urinary incontinence severity, symptom distress, quality of life, urinary incontinence episodes, voiding intervals, treatment satisfaction, and adherence in women with persistent mixed urinary incontinence following completed PFME therapy. Participants were stratified according to age, educational level, body mass index, mode of delivery, and baseline urinary incontinence severity before randomization to an intervention group or a control group. The intervention group received an individualized 8-week bladder training program supported by smartphone alarm reminders and distraction techniques, whereas the control group received routine outpatient care. Clinical outcomes were assessed using validated questionnaires, bladder diaries, and the standardized one-hour Pad Test.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

Interventions

Bladder Training Supported by Alarm Reminders and Distraction TechniquesBEHAVIORAL

Participants received an individualized 8-week bladder training program supported by smartphone alarm reminders and distraction techniques. The intervention included pelvic floor muscle contractions, urgency suppression strategies, timed voiding with gradually increasing voiding intervals, smartphone alarm reminders, and bead-counting distraction techniques.

Routine Outpatient CareOTHER

Participants received routine outpatient follow-up care without structured bladder training during the study period.

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: Women aged 18-65 years. * Physician-diagnosed mixed urinary incontinence. * Previously received pelvic floor muscle exercise (PFME) as the sole treatment for urinary incontinence. * Completed PFME therapy at least six months before enrollment. * Continued to experience urinary incontinence symptoms after completion of PFME therapy. * Owned and were able to use a smartphone. * Were not receiving any active treatment for urinary incontinence during the study period. * Provided written informed consent. Exclusion Criteria: * Urinary tract infection. * Neurological disorders affecting bladder function. * Pregnancy. * Active treatment for urinary incontinence. * Previous bladder training. * Previous biofeedback therapy. * Previous magnetic chair therapy. * Cognitive impairment. * Any medical condition that could interfere with participation or completion of the study.

Outcomes

Primary Outcomes

Urinary Incontinence Severity

Urinary incontinence severity was assessed using the Incontinence Severity Index (ISI). Higher scores indicate greater urinary incontinence severity.

Time frame: Baseline and Week 8

Secondary Outcomes

Objective Urine Loss

Objective urine loss was measured using the standardized one-hour Pad Test.