Change in depression predicts change in bladder symptoms for women with urinary incontinence undergoing pelvic-floor muscle training.

INTRODUCTION: To examine the relationship between depression and bladder symptoms, especially the impact of change in depression on changes in bladder symptoms, for women with urge and stress urinary incontinence undergoing a course of PFMT. METHOD: 106 adult females with pelvic-floor dysfunction (PFD), consecutively referred to an outpatient pelvic-floor muscle training (PFMT) programme for either urge, stress, or mixed incontinence, participated in a prospective observational study. Participants reported subjective views of their pelvic floor problems (Queensland), and their levels of depression (HADS_D), and data relating to age and BMI were collected. The trial was registered on clinicaltrials.gov (NCT02549157). RESULTS: There was a positive relationship between depression and bladder symptoms at intake. Levels of initial depression significantly predicted levels of bladder symptoms at completion of PFMT, and ability to complete the PFMT programme. Change in depression significantly predicted change in bladder symptoms, over and above intake patient characteristics and symptoms. DISCUSSION: These data imply a multidisciplinary focus, including psychological input, for PFD may be a highly effective strategy for its management.