Comparing the Effect of Tolterodine, Biofeedback (Pelvic Floor Muscles Training) and Drug plus Biofeedback on Quality of Life and Urge Urinary Incontinency in Patients Referred to Imam Khomeini Hospital in 2014

Background Urgency is a characteristic for overactive bladder and is defined by a sudden obligatory need for urination, a feeling that can be hardly stopped. Many methods such as drug therapy and feedback have been used to treat urinary incontinency. Objectives The aim of this study was to assess and compare the effect of medication, biofeedback or biofeedback plus medication on urge- urinary incontinency and quality of life of patients. Methods This was a case-control randomized clinical trial performed on patients referred to Imam Khomeini hospital in 2014. Patients were divided into three groups of drug (Tolterodine), biofeedback, and biofeedback plus drug. Biofeedback group underwent two sessions of treatment weekly for four weeks, and the drug group received tolterodine (4 mg slow release) for four weeks. The third group received both of them. Quality of life and urinary incontinency symptoms were compared between the three groups and analyzed, using SPSS Version 16 software (IBM, Armonk, USA). Results Meaningful differences were observed between the three groups with respect to change in the total score of the questionnaire (P < 0.001). Between the groups, drug therapy had the most effect on improving the total score of the questionnaire, with a mean change of 25.44 ± 1.80. No meaningful difference was observed between drug plus biofeedback and biofeedback group (P = 0.114). By comparing the mean incontinency score, we found a meaningful difference between the drug and biofeedback groups and the biofeedback and biofeedback plus drug groups (P < 0.001 and P < 0.002, respectively); however, no meaningful difference was found between the biofeedback plus drug group and the drug group in mean incontinency score (P = 0.187). Conclusions Our study results revealed that tolterodine and biofeedback both increased quality of life indices and decreased the severity of urinary incontinency significantly in our participants. However, drug plus biofeedback treatment improved the severity and quality of urinary incontinency, but did not improve quality of life of the patients. Therefore, physicians should consider improving the quality of life of patients as well.