Timed voiding RCTs

StudyStudy type and ELNo. of patientsPatient characteristicsInterventionComparisonLength of follow-upOutcome measuresEffect sizeAdditional comments
Colling 1992332Cluster RCT
EL = 1−
113 randomised (82% women), 88 completedNursing home M/F residents ≥ 65 years, ≥ 3 UI episodes/week in last 2 weeks, able to state name or place of residence, toilet with assistance of 1 person only. 73% urge UI, 27% mixed UI. Urodynamic residual vol. means 79 and 86 ml; vol. at strong desire to void means 243 and 235 mlIndividualised scheduled toileting (‘pattern urge-response toileting’ (n = 63)Control (n = 50)36 weeks (12 weeks baseline, 12 weeks tx, 12 weeks follow-up)Leakage episodes/day (mean change vs baseline)−0.9 vs 0 (24 weeks)
−0.3 vs +0.7 (36 weeks)
Funding: Facilities reimbursed for staff time in the project.
Cluster RCT because nursing home staff carried out the toileting programme. NH staff given 4 h educational programme (causes and consequences of UI, info re the programme). Project staff provided encouragement to nursing staff throughout the programme to comply with the toileting schedule.
Toileting schedule: toilet within 30 min prior to an individual’s mean time of voiding, as captured during 12 week baseline using electronic data logger.
Withdrawals; 12 vs 13 active vs control grps.
Although a cluster RCT, findings reported for individuals not by nursing home.
Volume voidedNo numerical data. No sig. difference between grps at any time point (as shown by CI on graph)
Tobin 1986333RCT
EL = 1+
278 (83% women)M/F, residential home residents, mean age 82 years, 78% had ‘chronic brain failure’ (score of ≤ 6 on 10-point mental status questionnaire), 93% women and 97% men had UI owing to unstable bladder contractions (overall 74% had unstable bladder, 19% unstable bladder and stress UI; 3% stress UI alone, 4% ‘other’)Timed voiding for unstable bladder + propantheline 15 mg + flavoxate 200 mg q.d.s.; and PFMT for females with stress UI (n = 174)No advice (usual care) (n = 104)8 weeksDaytime leakage episodes (% reporting improvement)40/102 (39%) vs 26/89 (29%), P = NS
(remainder unchanged)
Funding: none declared.
Timed voiding: 2 hourly voiding.
[EL = 1−] it is unclear how many offered PFMT, or what training entailed. Also, antibiotics were given for UTI, and ethinylestradiol 30 μg/day for 3 weeks for women with atrophic vaginitis (number not stated).
Night-time leakage episodes (% reporting improvement)39/95 (41%) vs 18/79 (23%), P = 0.016
(remainder unchanged)
Pad test (% showing improvement)16/65 (25%) vs 11/45 (24%), P = NS
43% vs 44% unchanged
32% vs 31% worse
Jirovec 2001334RCT
EL = 1−
118 (69% women) randomised, 74 completedM/F mean age 80 years, memory-impaired, having caregiver support at home. 60% some symptoms of urgency, 18% positive stress test, PVR (bladder scan) mean 64 mlIndividualised scheduled toileting with 3×2 month visits (n = 38) or 1×6 month visit* (n = 39)
[results from both grps combined; 44 analysed]
Control (n = 41)6 months% with reduced leakage episodes/day28/44 (64%), P < 0.05 vs baseline vs 15/30 (50%)
no between-grp comparisons
Funding: National Institute of Nursing Research.
Individualised training programme; scheduled toileting according to voiding pattern (most ~2 h), education re fluid intake (consistent, minimum 6× 8 oz glasses/day); monthly phone calls, advice on environment (Obstacles to urine control), visits every 2 or 6 months (*group originally randomised to 3× 2-month or 1× 6-month visit – because incontinence similar in both grps, results were combined).
Control grp: given monthly visits and paid $25.
Withdrawals; 33 vs 11 active vs control grps.
Leakage episodes/day (mean change)−0.06 (14%) vs −0.02 (4%)

From: Evidence tables for included studies

Cover of Urinary Incontinence
Urinary Incontinence: The Management of Urinary Incontinence in Women.
NICE Clinical Guidelines, No. 40.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2006 Oct.
Copyright © 2006, National Collaborating Centre for Women’s and Children’s Health.

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