Web-based Management of Female Stress Urinary Incontinence

Web-based Management of Female Stress Urinary Incontinence. Evaluation of a Treatment Programme With Pelvic Floor Muscle Training and Elements of Cognitive Behavioural Therapy

Swedish Council for Working Life and Social Research, Jämtland County Council, Sweden, Västernorrland County Council, Sweden

The purpose of this study is to determine whether treatment of female stress urinary incontinence using a web-based programme is effective.

Female urinary incontinence is very common and affects up to one fourth of grownup women. It may reduce quality of life for those affected and costs for society are high. The most common type of urinary incontinence is stress urinary incontinence (SUI), i.e leakage when coughing, sneezing or jumping. There is no association between SUI and serious medical conditions. Thus investigation can be kept to a minimum, including structured history taking and a bladder diary for correct diagnosis. Treatment with lifestyle intervention and pelvic floor muscle training (PFMT) give improvement or cure in 60-70% of women. A small study indicates that treatment with cognitive behavioural therapy (CBT) may improve incontinence-related quality of life and symptoms of urinary incontinence. Web-based management of SUI has as far as we know never been evaluated in a randomized controlled study. The aim of this study is to determine if web-based management of female SUI, with a treatment using PFMT and elements of CBT is effective compared to treatment supported by a pamphlet. The duration of the treatment programme is three months, follow-up at four months, 1 year and two years.

female, stress urinary incontinence, treatment, pelvic floor muscle training, cognitive behavioral therapy, internet, life style, pamphlet, eHealth

Web-based treatment with information (including life style), PFMT, elements of CBT and regular mail contact with an urotherapist

125 women with stress urinary incontinence(SUI) participate in web-based treatment for 3 months. Treatment consists of information, PFMT and uses elements of CBT. It includes regular email contact with urotherapist.

International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF)

International Consultation on Incontinence Modular Questionnaire Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTSqol)

condition-specific quality of life, summed score, range 19-76, higher scores indicate greater impact on quality of life.

Inclusion Criteria: stress urinary incontinence leakage once a week or more often ability to read and write Swedish asset to computer with Internet connection Exclusion Criteria: pregnancy former incontinence surgery known malignancy in lower abdomen difficulties with passing urine visual blood in urine intermenstrual bleeding severe psychiatric diagnosis neurological disease with affection on sensibility in legs or lower abdomen

Sjostrom M, Umefjord G, Stenlund H, Carlbring P, Andersson G, Samuelsson E. Internet-based treatment of stress urinary incontinence: a randomised controlled study with focus on pelvic floor muscle training. BJU Int. 2013 Aug;112(3):362-72. doi: 10.1111/j.1464-410X.2012.11713.x. Epub 2013 Jan 25.

Sjostrom M, Stenlund H, Johansson S, Umefjord G, Samuelsson E. Stress urinary incontinence and quality of life: a reliability study of a condition-specific instrument in paper and web-based versions. Neurourol Urodyn. 2012 Nov;31(8):1242-6. doi: 10.1002/nau.22240. Epub 2012 Apr 19.

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