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Many women with urinary incontinence--the lack of voluntary control of the bladder--can be taught bladder control techniques that will help them avoid the need for medications.

A study reported in the Journal of the American Medical Association (1998;280:1995-2000) found that more women gained control of their bladder through "behavioral therapy" than through drugs. The study included 197 women who suffered from urge incontinence--the sudden urge to urinate and the inability to make it to the toilet in time. The women were either prescribed a medication called oxybutynin (Ditropan) or taught bladder control techniques with biofeedback. During biofeedback, women were connected to a device that gave a graphic display of the activity of their bladder muscles. They were encouraged to pause and contract the bladder muscles repeatedly to reduce the urgency.

Symptoms improved during the 8-week study in 81% of the behavioral therapy group compared with 68.5% of the drug therapy group, reported Kathryn L. Burgio, PhD, of the University of Alabama at Birmingham. However, neither method was evaluated for its long-term effectiveness. The American Urological Association points out that when drugs are prescribed, patients are usually instructed in bladder control techniques as well. A combination of the two may be the best approach.

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