Behavioral training for stress and urge incontinence in the community.

Behavioral training procedures provide an effective, low-risk approach to the treatment of persistent urinary incontinence. This paper describes the use of biofeedback techniques for the operant conditioning of physiological responses, such as selective contraction of pelvic floor muscles and voluntary inhibition of detrusor contraction, that mediate bladder control. The effectiveness of biofeedback-assisted behavioral training for most independent-living older adults is documented in several research studies. The data indicate that behavioral treatment of stress or urge incontinence results in improvement rates which range from 78 to 94%. The role of biofeedback in behavioral training and its practicality for use in office practice are also discussed.