Table 7: Existing Systematic Reviews on Patient-Directed Behavioural Techniques for the Treatment of Urinary Incontinence^*.

Systematic Review, Year	Intervention	Number of Studies Included in Review	Results and Conclusions	Comments
Wallace et al., 2004 Updated in 2006 Cochrane review (29)	Bladder training	12 studies; 8 studies provided usable data	Clear conclusions regarding the effectiveness of bladder training are difficult to make based on the limited evidence available. Compared with no bladder training, point estimates of effect favoured bladder training; however, CI were wide and no statistically significant differences were found.	Not limited to seniors Only 2 of 12 studies where majority of population >65 y
Teunissen et al., 2004 (38)	Behavioural therapy and drug therapy in community-based seniors	4 before-after studies 4 RCTs	Behaviour therapy, including PFMT, is effective in reducing urinary leakage (5 studies). Behaviour therapy appears more effective than drug therapy in seniors (3 studies). There is insufficient high-quality evidence to make conclusions regarding drug therapy in seniors.	Not limited to RCT evidence
Choi et al., 2007 (30)	PFMT versus no treatment	12 studies	Studies heterogeneous in terms of types of incontinence, eligible ages, duration of PFMT. PFMT is effective in reducing Incontinent episodes (MWES −0.68; 95% CI, −0.91 to −0.46); Urine leakage amount (MWES −1.48; 95% CI, −2.58 to −0.38); and Perceived severity (NS) (MWES −1.66; 95% CI, −3.59 to 0.27).	Only 5 of 12 studies where majority of population >65 y Included studies with multicomponent behavioural interventions and not just PFMT alone
Hay-Smith et al., 2006 Cochrane review (31)	PFMT alone versus no treatment	13 studies; 6 studies contributed data to the analysis	Considerable variation among studies in inclusion criteria, interventions and outcome measures Patient perceived cure more likely after PFMT than control Fewer incontinent episodes with PFMT than control May be improved condition-specific quality of life with PFMT compared with control Treatment adherence likely to impact size and direction of treatment effect, but difficult to measure No serious adverse effects reported Final conclusion: PFMT is better than no treatment for women with stress, urge, or mixed UI.	Excluded trials where PFMT was combined with another conservative therapy (to be examined in future reviews) Only 3 of 13 studies where majority of population >65 y Did not pool estimates of effect

^*CI refers to confidence interval(s); MWES, mean weighted effect size; NS, not significant; PFMT, pelvic floor muscle training; RCT, randomized controlled trial; UI, urinary incontinence.