Urinary Incontinence, Urge Clinical Trial
Official title:
Protocol for Brain-Centered Therapy Versus Medication for Urgency Urinary Incontinence An RCT: Hypnotherapy Or Pharmacotherapy
This study is randomized controlled trial in which urgency incontinent women (approximately 150-160) will be randomized to hypnotherapy or pharmacotherapy and evaluated at months 2, 6 &12 Hypotheses: Among patients with urgency urinary incontinence (UUI), hypnotherapy will be non-inferior pharmacotherapy in diminishing UUI episodes. Hypnotherapy may be superior or may not differ from pharmacotherapy in diminishing symptoms or quality of life based on validated questionnaires and/or other diary parameters.
Study Objectives Primary: To compare change in Urgency Urinary Incontinence (UUI) episodes at
2 month follow-up on voiding diaries between hypnotherapy and pharmacotherapy groups (to
determine whether hypnotherapy is at least as effective and durable in treating UUI as
pharmacotherapy)
Secondary Analyses:
- To determine whether hypnotherapy is at least as effective in treating UUI as
pharmacotherapy comparing change in UUI episodes on voiding diary at 6 and 12 month
follow-up
- To determine whether hypnotherapy differs from pharmacotherapy in treating UUI comparing
change in questionnaire results and urinary frequency
- enrolled following administration of the Overactive Bladder (OAB) Awareness tool.
Participants will keep voiding diaries then be randomized to either pharmacotherapy and
conventional behavioral therapy or hypnotherapy and conventional behavioral therapy.
Approximately 150-160 women will be randomized.
Randomization will occur using a computer-generated randomization scheme in varying permuted
block sizes. Study personnel performing data entry will be masked to participants' treatment.
Masking participants to treatment is not feasible. Participants will be followed at 2,6 & 12
months. Measurements will be performed before treatment, following completion of treatment
visits (approximately 8 weeks), and at 6 and 12 months. Primary analysis will be intention to
treat. Exploratory analyses of secondary outcomes will also be performed.
Study Visits: UUI participant screening: Study information given. Screening questionnaire
given. Visit 1 Enrollment: Formal screening for eligibility, voiding diary reviewed, if
eligible, written consent obtained with administration of study questionnaires, demographic
and past medical history administration forms, Pelvic Organ Prolapse Quantitation (POP-Q)
exam & hypnotic susceptibility testing scheduled. Pariticipants undergo hypnotic
susceptibility testing prior to randomization. Participants randomized to treatment and
contacted, treatments arranged. Hypnotherapy group: undergo weekly treatments over 8 weeks.
Pharmacotherapy group: weekly counseling sessions over 8 week: Following hypnotherapy or
medication counseling completion, f/u voiding diaries collected & study questionnaires
administered. One of two long acting anti-cholinergic medications offered (Long acting
Tolterodine or Extended Release Oxybutynin or equivalent generic substitutes).
6 & 12 month follow-up: Pharmacotherapy subjects receive medications for 1 year and
Hypnotherapy subjects encouraged to continue self-hypnosis for 1 year with assistance of
audio-recordings, with 1 optional hypnotherapy session between 6-12 months..
Participants informed pharmacotherapy & hypnotherapy sessions are audio-recorded and reviewed
ensuring manual of procedures are followed.
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