Behavioral therapy + pelvic floor muscle training for overactive bladder syndrome

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Created On: 20/02/2026

This study examined the effectiveness of combined behavioral therapy (BT) and pelvic floor muscle training (PFMT) versus either therapy alone in women with overactive bladder (OAB) syndrome.

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Key take away

Combining behavioral therapy with pelvic floor muscle training improves urinary symptoms, pelvic floor strength, and overactive bladder in women compared to either therapy alone.

Background

This study examined the effectiveness of combined behavioral therapy (BT) and pelvic floor muscle training (PFMT) versus either therapy alone in women with overactive bladder (OAB) syndrome.

Method

In this prospective, randomized controlled trial, 110 women with OAB were divided into three groups: BT+PFMT, BT only, and PFMT only. The 3-month combined therapy program included bladder training, urgency suppression techniques, lifestyle modifications, motivational strategies, and pelvic floor exercises, while the isolated BT and PFMT groups followed their respective protocols.

The key endpoints were OAB cure, defined as an OAB-V8 score <8 with no urgency urinary incontinence episodes. Secondary endpoints included urinary symptom improvement, pelvic floor muscle (PFM) strength, adherence to exercises, and patient-reported subjective cure.

Result

Women receiving combined BT+PFMT exhibited markedly higher rates of OAB cure than those receiving BT or PFMT alone. In per-protocol analysis, BT+PFMT patients were 5.5 times more likely to attain objective OAB cure than PFMT alone (odds ratio [OR] 5.5) and 4.1 times more likely than BT alone (OR 4.1).

Intention-to-treat analysis confirmed superior potency of the combined therapy (OR 3.4). All groups exhibited improvement in PFM function, including strength, endurance, and fast contractions, with PFMT-inclusive groups illustrating the greatest gains.

Conclusion

Combining BT with PFMT proved more valuable than isolated therapies in treating female OAB, improving both urinary symptoms and pelvic floor function. This integrated approach should be considered a first-line, non-pharmacologic therapy for OAB care.