A recent study published in Modern Medicine Magazine says that Pelvic floor exercises are safer and significantly more effective than medication for managing both stress and urgency urinary incontinence. It also said that regardless of the therapeutic approach, patient compliance is critical to long-term success.

Overall, drugs for urinary incontinence (UI) were said to have relatively little benefit, as side effects kept compliance low, and long-term safety was still questionable. Contrastingly pelvic floor exercises could make a significant difference if women stuck with it, according to a Comparative Effectiveness Review conducted by the Effective Health Care Program arm of the American Agency for Healthcare Research and Quality (AHRQ).

The analysis of 905 studies found that nonpharmacologic treatment—Pelvic Floor Exercises —can result in significant benefit, making up to 100% difference in incontinence rates, with no adverse effects. Similar rates of success were reported, regardless of whether patients used biofeedback with the exercises.

By comparison, the report noted that drug treatments are more effective than placebo, but the degree of benefit was low for all drugs, with fewer than 200 cases of continence attributable to treatment per 1,000 women. Dry mouth, constipation, and blurred vision were cited as the side effects chiefly responsible for low compliance with the prescription drugs.

Women with daily stress urinary incontinence perceive clinical benefit from a treatment when frequency is reduced approximately 50%, but they typically only report improved quality of life and clinical success when they experience at least a 70% reduction in frequency. Similarly, more than 60% of women with persistent urgency, stress, or mixed urinary incontinence report complete treatment satisfaction when they experience more than 70% reduction of incontinence episodes.

The review reports that available diagnostic tests are of minimal value in distinguishing women with stress or urgency urinary  inconitinence. Although nonsurgical treatment decisions are driven by clinical evaluation with validated tools for diagnosis of urinary incontinence, multichannel urodynamics was no more accurate than patients’ self-reports of symptoms at predicting who would benefit from nonsurgical options.