If you’re a woman living under the shadow of a condition called urinary urge incontinence, don’t endure it any longer. A clinical study under way at the Health Science Center offers free medication and behavioral therapy with the goal of discontinuing the medication. If you complete the study activities, you’ll be compensated $350 for your time and effort. All participation will be kept confidential.
The Behavior Enhances Drug Reduction of Incontinence (BE-DRI) study in the Health Science Center’s department of urology is testing the hypothesis that the addition of behavioral treatment to drug therapy will enable patients to discontinue their medication and improve or cure their urinary urge incontinence.
BE-DRI study participants get three physician visits for free; a comparable appointment with a specialist for this particular problem begins at $100 per visit.
The study physicians are Stephen Kraus, M.D., assistant professor and principal investigator, and Thomas A. Rozanski, M.D., professor. Women from Bexar and surrounding counties may call Sylvia Escobedo Sluder at (210) 567-0550 or Caren Prather at 567-0548.
Urinary incontinence affects 16 million Americans, two-thirds of whom are women. The results are social isolation, depression, and sexual and relationship problems. The problem is under-reported and under-treated because individuals often do not want to discuss it with a doctor.
There are important ramifications to taking medication for the problem long term. The most-common side effects include dry mouth and constipation, depending on which medication is prescribed. The medication in the BE-DRI study has one of the lowest incidences of side effects.
“And there are financial considerations,” Dr. Kraus said. “If people take the medication chronically, of course the cost adds up. Since no one has ever done a randomized clinical trial to see if patients need to remain on the medications, we really don’t know if they need to remain on them or not. This clinical trial will raise the bar with regard to the quality of the information we have.”
The Problem: Urinary Urge Incontinence• The bladder begins to contract without permission or involuntarily.
• The person feels a strong sudden urge to urinate wherever they are – close to a bathroom or not.
• This differs from urinary stress incontinence, in which leakage is associated with coughing, sneezing, laughing or other physical activities.
• Stress incontinence happens because the urethral sphincter or valve opens and allows urine to leak with the increased pressure on the bladder caused by such activities.
• Mixed incontinence is a combination of urge and stress incontinence. Women with a stress incontinence component can participate in BE-DRI, but they must have urge incontinence and the urge incontinence must be more bothersome.
How the Study Works• Both groups of women in the BE-DRI trial receive medication to block bladder contractions. The duration of the treatment is 10 weeks.
• Roughly half of the ladies receive intensive behavioral counseling.
• Eight months after the start of the study – 5 1/2 months after therapy is withdrawn – outcomes of the combination-therapy group and the medicine-only group will be compared to see if the women in the combination-therapy group have fewer episodes of urge incontinence.
• The study is funded by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases. About 35 women from the San Antonio area are sought.
