Pelvic Exercises Cut Men's Urge To Go

A new study shows men with overactive bladder may benefit from pelvic floor exercises long known to help women plagued by the problem.

And the exercises worked as well as medications, researchers found.

"Behavioral treatment is just as effective as drug treatment in males with overactive bladder, and that's big," said Dr. Jason M. Hafron, a urologist at the William Beaumont Hospital in Royal Oak, Michigan, who wasn't involved in the new work. "It's safer, cheaper, and it's effective. This study will increase awareness that exercise is an option."

People with overactive bladder experience a strong, sudden urge to urinate that may lead to incontinence. There are several behavioral changes that can make coping easier, but often drugs are prescribed, too.

In the latest study, researchers looked at 143 middle-aged and older men who continued to have urinary problems despite taking drugs called alpha-blockers.

They randomly assigned the participants to either take an additional drug called oxybutynin (Ditropan XL) or practice behavioral techniques for eight weeks. The techniques included restricting fluids in the evening, controlling urinary urge at night, and training their pelvic floor muscles.

For the exercises, men were taught to contract their pelvic floor muscles for two to 10 seconds and then relax them for a similar amount of time. They were asked to repeat the sequence 45 times per day, usually split into three smaller sessions.

During the study, men in both groups went from urinating about 11 times a day to nine times a day, according to diaries they kept of their progress. Those who did exercises also cut their nightly bathroom visits by five times per week, compared to only two among the men who only took drugs.

Overall, more than 90 percent of the men said they were completely or somewhat satisfied with the treatments, according to Dr. Theodore M. Johnson II and colleagues.

Their findings are published in the Journal of the American Geriatrics Society.

According to Johnson, chief of geriatrics at Emory University in Atlanta, the new research is among the first to test pelvic exercises in men with bladder control problems.

"What's important about this trial is that it studies an approach used in women in men to see if an exercise-and-behavior approach can be useful," Johnson said. "If you don't respond well to one drug for your symptoms, you may not need another drug if you're willing to do exercises."

Researchers have estimated that about one in six Americans has overactive bladder. Hafron said the problem is frequently diagnosed in women, but is underdiagnosed in men, because the symptoms are often mistaken for prostate problems.

Drug treatment is effective for some people, but side effects such as dry mouth and constipation are common, leading many to stop taking the medications after a few months.

"The important thing about behavioral exercise is that it's free," Johnson concluded. "It costs you just time and it's free of side effects. As long as you do the exercise, you have a good chance of some benefits and it may take less than two months."