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Self-management of stress urinary incontinence via a mobile app: two-year follow-up of a randomized controlled trial [with consumer summary]
Hoffman V, Soderstrom L, Samuelsson E
Acta Obstetricia et Gynecologica Scandinavica 2017 Oct;96(10):1180-1187
clinical trial
3/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: We investigated the long-term effects of using a mobile app to treat stress urinary incontinence with a focus on pelvic floor muscle training. MATERIAL AND METHODS: A previous randomized controlled trial of 123 women aged 27 to 72 years found that three months of self-managing stress urinary incontinence with support from the Tat app was effective. We followed up the women in the app group (n = 62) two years after the initial trial with the same primary outcomes for symptom severity (International Consultation on Incontinence Questionnaire Short Form) and condition-specific quality of life (ICIQ-Lower Urinary Tract Symptom Quality of Life) and compared the scores with those at baseline. RESULTS: Of the 62 women, 61 and 46 (75.4%), respectively, participated in three-month and two-year follow-ups. Baseline data did not differ between responders and non-responders at follow-up. The mean decreases in International Consultation on Incontinence Questionnaire Short Form and ICIQ-Lower Urinary Tract Symptom Quality of Life scores after two years were 3.1 (95% confidence interval 2.0 to 4.2) and 4.0 (95% confidence interval 2.1 to 5.9), respectively. Of the 46 women, four (8.7%) rated themselves as very much better, nine (19.6%) as much better, and 16 (34.8%) as a little better. The use of incontinence protection products decreased significantly (p = 0.04), and the proportion of women who felt they could contract their pelvic muscles correctly increased from 14/46 (30.4%) at baseline to 31/46 (67.4%) at follow-up (p < 0.001). CONCLUSIONS: Self-management of stress urinary incontinence with support from the Tat app had significant and clinically relevant long-term effects and may serve as first-line treatment.

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