Comparing Approaches to Treat Older Adult Women's Urge Incontinence: Pilot Feasibility and Randomized Controlled Trial (SHUW)

Inclusion Criteria:

The following eligibility criteria must be met for the potential participant to be considered for enrollment.

• The study is enrolling older adult women, with urinary urge incontinence.
• They cannot be currently treating their urinary urge incontinence with medication as this will confound results.
• Women who have attempted more extreme treatments and are still experiencing urinary urge incontinence will not be considered as potential participants, as it is unlikely that mindfulness-based stress reduction would treat urinary urge incontinence that is refractory to that degree.
• Participants must be English speaking, as the interventions and homework will be delivered in English.
• postmenopausal women
• Urge predominant urinary incontinence, defined as score of ≥ 3 (moderate to severe urinary incontinence) on the Incontinence Severity Index
• Urge predominant urinary incontinence as determined by question 3 on the 3 Incontinence Questions. The 3 Incontinence Questions has been shown to be a quick and accurate way of diagnosing stress, urge or mixed incontinence in most cases
• Has experienced urinary urge incontinence symptoms for at least three months
• Committed to attend 8 weekly sessions and one half day retreat between weeks 6 and 7
• No pharmacologic therapy for urinary urge incontinence within three weeks of enrollment and no plan to initiate such medications during the 8 week active treatment
• If on hormone therapy or vaginal estrogen, plan to remain on it for the duration of the study; if not on it, no plan to initiate
• No previous intradetrusor Botox injection for urinary urge incontinence and no plan to receive it during the intervention
• No previous neurostimulation for urinary urge incontinence and no plan to receive it during the intervention English speaking
• A score of >24 on the Montreal Cognitive Assessment

Exclusion Criteria:

The following exclusions are applied, as they could seriously limit participation or confound participant response to the intervention:

• Predominantly stress, mixed, or other type of incontinence as determined by question 3 on the 3 Incontinence Questions
• Currently taking medications for Alzheimer's disease or other dementias; these medications could interfere with their participation
• Known neurologic disease acknowledged to impact bladder function including Parkinson's disease, spinal cord injury, or stroke affecting urinary control; these diseases provide cause for urinary urge incontinence and as such the participant would be unlikely to benefit from the intervention
• Current symptomatic urinary tract infection that has not resolved prior to the start of intervention
• Current bladder infection that has not resolved prior to the start of intervention
• Use of an assistive device for ambulation (such as a cane, walker, or wheelchair) and feels that difficulties with bladder management are related to the slowed time in visiting the restroom ("Was urinary urge incontinence a problem before you began using the assistive device?")
• Functionally incontinent, in other words, having a mental or physical condition that prevents a person from visiting the restroom in time
• Ever diagnosed with interstitial cystitis
• Self-report of vaginal bulge protruding outside of the vagina
• Past participation in a formal program of mindfulness-based stress reduction
• Substantial, uncorrected hearing loss
• Substantial, uncorrected vision loss
• Limitations that preclude completing study questionnaires or surveys, such as difficulties with reading and writing or a cognitive impairment