Biofeedback does not add benefit to structured training for stress or mixed urinary incontinence in women

Reference

Hagen S, Elders A, Stratton S, et al. Effectiveness of pelvic floor muscle training with and without electromyographic biofeedback for urinary incontinence in women: multicentre randomised controlled trial. BMJ 2020;371:m3719.

Synopsis

These investigators enrolled 600 women (average age 48 years) who initially sought care for stress or mixed urinary incontinence at 1 of 23 continence care centers. The women were randomized, using concealed allocation, to receive structured pelvic floor muscle training with or without electromyographic feedback, which captures the electrical activity of the pelvic floor muscles. Pelvic floor muscle training consisted of 6 appointments with a continence therapist and an individualized exercise program to be continued at home. Patients in the feedback group also used electromyographic feedback during appointments and at home. Using a self-administered incontinence questionnaire, approximately half the women had severe incontinence (score of at least 13 out of a possible 21). At 6, 12, and 24 months, scores in both groups dropped similarly, from baselines of 12.3 and 12.5 to 8.2 and 8.5. Quality of life, voiding, or incontinence scores were not different between the 2 groups. The study doesn't answer the question of whether the biofeedback device can be used in lieu of the structured training provided in this study.