Observed patient compliance with a structured outpatient bladder retraining program

Objective: Our purpose was to determine patient compliance with a telephone-based retraining program. Study Design: This was a retrospective study of 123 women with urinary urgency or urge incontinence who were offered bladder retraining with facsimile machine submission of a retraining diary and weekly telephone feedback. Results: Completion was defined as having ≥4 follow-up sessions and ≥6 weeks of retraining. Seventy-one percent (87/123) began the retraining program; 63% (55/87) of them completed it, for an overall compliance rate of 45% (55/123). When we compared those who completed retraining with those who started but did not complete it, only concurrent use of pharmacologic therapy was significantly different (87% vs 53%, respectively; P< .001). This difference remained significant after we controlled for other independent variables, including urodynamic diagnosis and physician. Conclusions: A total of 55% of women to whom telephone-based bladder retraining was recommended either never started or were noncompliant with the treatment. Bladder retraining success in the “real world” may be substantially lower than that described in well-funded labor-intensive clinical trials. (Am J Obstet Gynecol 1999;181:1392-4.)