Plenary: Next Frontier, Sunday
Plenary: Next Frontier
Presentation Authors: Ananias C Diokno*, Royal Oak, MI, Lisa Kane Low, Ann Arbor, MI, Diane K Newman, Philadelphia, PA, Kathryn Burgio, Birmingham, AL, Tomas L Griebling, Kansas City, KS, Michael Maddens, Royal Oak, MI, Leslee Subak, San Francisco, CA, Carolyn Sampselle, Ann Arbor, MI, Ann Robinson, Royal Oak, MI, Trevillore Raghunathan, Ann Arbor, MI, Judith Boura, Donna McIntyre, Royal Oak, MI
Introduction: Primary aim: to compare the effectiveness and safety of a group-administered behavioral treatment program (GBT) to no treatment in older women with stress, urgency, or mixed urinary incontinence (UI).
Methods: Recruitment letters were mailed to women 55 years and older at three sites (Alabama, Michigan & Pennsylvania) seeking UI naïve to previous therapy. Responders were screened by phone and eligible respondents were referred to sites for clinical screening and randomization. Inclusion/exclusion criteria included age 55+, International Consultation on Incontinence questionnaire (ICIQ-SF) score at least 3 (1 for frequency, 2 for severity), minimum 3-months duration, no prolapse, previous bladder surgery or pelvic cancers. Primary outcome: ICIQ-SF. Secondary outcomes: 3-day voiding diary (VD), paper towel test, 24-hr pad test, Brink test, Patient Global Impression of Improvement (PGI-I) and other UI questionnaires. GBT group received a one-time 2-hour bladder health class whereas control received usual care. Both received behavioral education brochure, monitored every 3 months for 12-months; clinic visits at 3 & 12 months and mailed questionnaires at 6 & 9 months.
Results: 463 subjects were randomized to GBT (232) or control (231). 34 withdrew (GBT=22 & Control =12). Demographics were not significantly different between groups. Outcomes at 3, 6, 9 & 12 months showed significant differences in favor of GBT over control including ICIQ (p<0.0001) (Fig 1), # leaks @ VD (p0.0002), paper towel test (p0.0008), 24-hr pad weights (p0.0007), Medical, Epidemiologic & Social aspects of Aging questionnaire (MESA) (p<0.0001), Incontinence Quality of Life (IQOL) (p<0.0001) & PGI-I (p<0.0001) but not the Brink test for pelvic floor strength (p0.09-.9). No significant difference in adverse events or serious events were encountered in each group. (all p values at 12 months)
Conclusions: This novel GBT bladder health education program was safe & effective in reducing UI frequency, severity and bother and improving quality of life for older women with UI in the community. This easily scaled intervention increases opportunity to reach larger populations beyond clinical into community settings.
Source Of Funding: NIH/NIA # RO1AG043383
Oakland University William Beaumont School of Medicine
Ananias C. Diokno is currently serving as Professor of Urology at Oakland University William Beaumont School of Medicine in Rochester, Michigan. He served as Chief Medical Officer and Executive Vice President of Beaumont Health System in Royal Oak, Michigan from 2006-2013.
He received his MD degree at the Universtiy of Santo Tomas in Manila and his urology residency and fellowship from the University of Michigan in Ann Arbor, Michigan. He served as a faculty member at the University of Michigan for 14 years before he was appointed as Chair of the Department of Urology at William Beaumont Hospital in Royal Oak, MI where he served in that position from 1984 to 2007. He was named the first Peter & Florine Ministrelli Distinguished Chair in Urology in 2006.
He was elected President of the Michigan Urologic Society, North Central Section of the AUA, Geriatric Urologic Society, the Reed M.Nesbit Society and the Philippine American Urologic Society.
He published more than 250 journal articles and book chapters. He co-chaired the first ever US Public Health Guidelines for Urinary Incontinence in adults in 1992. He is currently the Editor in Chief of International Urology & Nephrology Journal. He has conducted 19 NIH funded research projects since 1984 and was a recipient of the NIH MERIT Award. He was honored as NAFC urologist of the year (2000), Lifetime Achievement award from SUFU (2002), the AUA Presidential Citation award (2007), the Victor Politano Award (2010) and the Outstanding Thomasian Alumni Award for research (2015).
Saturday, May 13
1:00 PM – 3:00 PM
Sunday, May 14
2:00 PM – 3:30 PM