Interventions for Overactive Bladder: Review of Pelvic Floor Muscle Training and Urgency Control Strategies

Background: Overactive bladder (OAB) is a common condition with a negative impact on quality of life. Physical therapists utilize multiple treatments for OAB, including behavioral training such as pelvic floor muscle training and urgency control strategies. Objectives: The purposes of this narrative literature review were to describe the rationale and theory for behavioral training techniques for OAB, review published evidence for these techniques, and discuss additional questions provoked by the review as well as future research directions. Study Design: Narrative literature review. Methods: A 2018 review of PubMed, CINAHL, the Cochrane database, and the Trip database yielded 12 articles appropriate for evidence analysis. Review of Literature: Pelvic floor muscle training for OAB has been studied by multiple authors. Most outcomes are favorable, but there is inadequate evidence to support any specific training protocol. Similarly, modalities to aid pelvic floor muscle training and/or reduce urinary urgency generally have positive results but published studies are difficult to compare and ideal treatment parameters are unclear. Cognitive strategies as a component of treatment for OAB, while commonly used clinically, are understudied at this time. Overall, while there is evidence to support behavioral training, the currently available literature on this subject leaves many unanswered questions. Conclusion: Behavioral treatment for OAB is well supported by solid theoretical rationales, but evidence for the treatment is equivocal and leaves practitioners with many unanswered questions. Studies on the details of behavioral therapy for OAB are strongly needed.