Comparison of Mindfulness-Based Stress Reduction Versus... : Urogynecology (original) (raw)

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Comparison of Mindfulness-Based Stress Reduction Versus Yoga on Urinary Urge Incontinence

A Randomized Pilot Study. With 6-Month and 1-Year Follow-up Visits

Baker, Jan APRN; Costa, Donna DHS; Guarino, Julie M. BSOT; Nygaard, Ingrid MD

From the Departments of *Obstetrics and Gynecology, and †Department of Occupational Therapy, University of Utah School of Medicine, Salt Lake City, UT.

Correspondence: Jan Baker, APRN, Department Obstetrics and Gynecology, University of Utah School of Medicine, Room 2B200, 1900 E 30 N, Salt Lake City, UT 84132. E-mail: [email protected].

The authors have declared they have no conflicts of interest.

No reprints will be available.

This study was funded by an unrestricted grant from the University of Utah and was also supported by the University of Utah Study Design and Biostatistics Center, with funding in part from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through grant 8UL1TR000105 (formerly UL1RR025764).

Objectives

The objective of this study is to compare the effects of mindfulness-based stress reduction (MBSR) versus yoga on urinary urge incontinence (UI) at 8 weeks, 6 months, and 1 year after beginning an 8-week program.

Materials and Methods

Participants in this prospective randomized single-masked pilot study were women aged 18 years or older with urge-predominant incontinence, 5 or more UI episodes (UIEs) on a 3-day voiding diary, and no recent anticholinergic use. Women were randomized to MBSR or yoga. The primary outcome was the percent change of UIE.

Results

Of 30 enrollees (15 in MBSR, 15 in yoga), 24 completed at least 5 of 8 sessions (13 in MBSR and 11 in yoga). Twenty and 21 women completed the 6-month and 12-month follow-up visits, respectively. At 8 weeks, 6 months, and 12 months, the median percent change from the baseline in UIE on the intention-to-treat analysis was greater for the MBSR group (−55.6, −71.4, and −66.7, respectively) compared with that for the yoga group (−33.3, −11.8, and −16.7, respectively), with P values ranging from 0.01 to 0.08. On intention-to-treat analysis, the median percent change in the Overactive Bladder Symptom and Quality of Life–Short Form and the Health-Related Quality of Life was greater at each time point for MBSR than for yoga but was statistically significant only at 8 weeks (P = 0.003 and 0.02, respectively). As per protocol analysis, at 8 weeks, 6/13 and 0/11 women in MBSR and yoga, respectively, reported they were very much or much better (P = 0.02), whereas at 1 year, 6/12 and 1/9 women in MBSR and yoga, respectively, did so (P = 0.16).

Discussion

These results support larger scale trials to evaluate MBSR, which seems to be a promising treatment of UI.