Physical activity, including yoga, reduces urinary incontinence in women

Key takeaways:

• Pelvic yoga did not significantly reduce UI in women compared with physical conditioning.
• However, the findings show that pelvic yoga does not worsen UI symptoms.

Both pelvic floor yoga and general physical conditioning reduced the incidence of urinary incontinence in middle-aged women, results from a randomized study showed.

Yoga failed to provide superior results compared with physical conditioning because both treatment strategies conferred similar yet significant reductions in daily urinary incontinence (UI) episodes.

According to Alison J. Huang, MD, MAS, a professor of medicine at the University of California, San Francisco, and colleagues, one in three middle- and older aged women experience UI, which has been tied to adverse health outcomes such as disability and poorer mental health.

“Nearly half of affected women report receiving no treatment, however, in part due to difficulty getting access to effective and well-tolerated UI therapies,” they wrote in the Annals of Internal Medicine.

The researchers explained that pelvic yoga could improve general skeletal muscle conditioning — a potential modifiable risk factor of UI — but the efficacy of it has not been thoroughly tested in trials. The study enrolled 240 women aged 45 to 90 years reporting daily urgency-, stress- or mixed-type UI. Researchers randomly assigned study participants to 12 weeks of either yoga or physical conditioning.

Participants in the yoga group underwent twice-weekly group instruction and once-weekly self-directed practice of pelvic floor-specific Hatha yoga techniques, whereas those in the physical conditioning group practiced general skeletal muscle stretching and strengthening exercises.

Patients used a diary to record UI frequency and type, which was measured by Huang and colleagues at baseline, 6 weeks and 12 weeks.

Researchers reported UI frequency of 3.4 episodes per day at baseline, which included 1.9 urgency-type episodes per day and 1.4 stress-type episodes per day.

Over the 12-week period, total UI frequency decreased by an average of 2.3 episodes per day in the pelvic yoga group and 1.9 episodes per day among those assigned to physical conditioning.

Huang and colleagues also found that urgency-type UI frequency decreased by 1.2 episodes per day in the pelvic yoga group and by one episode per day in the physical conditioning group.

Reductions in stress-type episodes per day did not significantly differ between the two treatment groups.

The researchers pointed out that although pelvic yoga did not show greater improvement on UI vs. physical conditioning, the findings help to relieve concerns that yoga could worsen UI symptoms “by increasing pressure on the bladder or precipitating urges to urinate,” they wrote.

“Nevertheless, approaches to yoga also vary widely in the community, and our findings may not extrapolate to all forms of yoga,” they wrote.

The study could not determine yoga’s effectiveness in reducing UI compared with no treatment because study protocol called for all participants to undergo one of two treatment interventions, Huang and colleagues explained.

“Future research should investigate potential effects of yoga on type-specific UI and factors underlying perceived improvements in UI among older women engaged in yoga and other physical interventions,” they concluded.