Reisch Becca, Das Rebekah, Gardner Brynne, Overton Katie
Pacific University Oregon, Hillsboro, OR, USA.
University of South Australia, Adelaide, SA, Australia.
Int Urogynecol J. 2021 Oct;32(10):2619-2629. doi: 10.1007/s00192-021-04720-2. Epub 2021 Feb 20.
Behavioral therapy is the first-line treatment for overactive bladder (OAB); however, the cognitive components of behavioral therapy for OAB have not been evaluated. The purposes of this systematic review were to describe the cognitive components of behavioral therapy for OAB and evaluate their effectiveness as well as to describe their rationale and origins.
Searches were conducted on the PubMed, CINAHL, Web of Science, Cochrane and PEDro databases. Inclusion criteria were single-arm or randomized controlled trials on OAB treatment that utilized behavioral therapy, with a description of a cognitive component of the behavioral therapy. Study participants were neurologically intact adults (n = 1169). Study methodological quality was assessed with the PEDro and Newcastle-Ottawa scales.
Five studies were included, published between 2009 and 2020. Methodological quality was variable. All studies reported a reduction of symptoms in participants receiving behavioral therapy. Cognitive components of behavioral therapy were not extensively described. Distraction was the most common cognitive strategy for managing urgency. The relative impact of the cognitive aspect of behavioral therapy could not be evaluated, and the cognitive aspects of behavioral therapy appear to be accepted wisdom, traceable to several key authors, that has not been subjected to scientific investigation.
Behavioral therapy for OAB appears useful, but its cognitive components are not well described, their relative importance has not been evaluated or ascertained, nor have they been rigorously studied.
行为疗法是治疗膀胱过度活动症（OAB）的一线疗法；然而，针对OAB的行为疗法中的认知成分尚未得到评估。本系统评价的目的是描述针对OAB的行为疗法的认知成分，评估其有效性，并描述其原理和起源。
在PubMed、CINAHL、科学网、Cochrane和PEDro数据库中进行检索。纳入标准为采用行为疗法治疗OAB的单臂试验或随机对照试验，并对行为疗法的认知成分进行了描述。研究参与者为神经功能正常的成年人（n = 1169）。采用PEDro量表和纽卡斯尔-渥太华量表评估研究方法的质量。
纳入了5项研究，发表时间为2009年至2020年。方法学质量参差不齐。所有研究均报告接受行为疗法的参与者症状有所减轻。行为疗法的认知成分未得到广泛描述。分散注意力是应对尿急最常见的认知策略。行为疗法认知方面的相对影响无法评估，行为疗法的认知方面似乎是可追溯到几位关键作者的公认观点，但尚未经过科学研究。
针对OAB的行为疗法似乎有效，但其认知成分描述不佳，其相对重要性尚未得到评估或确定，也未经过严格研究。
