Behavioral intervention for urinary incontinence in women: evidence for practice.

In the past, clinicians have relied heavily on pharmacologic and surgical interventions for urinary incontinence in women. However, evidence now exists that less invasive, behavioral therapies can be extremely effective in helping women become continent; thus, strategies that involve bladder and pelvic floor muscle training should generally be the first line of treatment. Before behavioral intervention is initiated, it is important to assess for any medical or associated conditions that should be treated first. Bladder training enables women to accommodate increasingly greater volumes of urine in the bladder and gradually to extend the interval between voiding. Pelvic floor muscle training increases awareness of function and strengthens these voluntary muscles, promoting continence.