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Comparison of Supervised versus Video-Assisted Pelvic Floor Muscle Training Combined with Tolterodine in the Treatment of Urge Incontinence: A Randomized Controlled Trial


1 Department of Urology, Lokman Hekim Hospital, Van, Türki̇ye
2 Department of Urology, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Türkiye
3 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Türkiye


DOI : 10.33719/nju1781256
New J Urol. 2026;21(2):53–59.
Abstract

Abstract

Objective: This study aimed to compare the clinical efficacy of physiotherapist-supervised versus video-assisted pelvic floor muscle training (PFMT) combined with tolterodine therapy in women with urge incontinence.
Material and Methods: In this prospective randomized controlled trial, 120 women aged 18–60 years with urge incontinence were randomized into two groups. Both groups received tolterodine 4 mg/day. The Video group (n = 60) performed home-based Kegel exercises with instructional video support. The Supervised group (n = 60) attended twice-weekly physiotherapist-supervised sessions. Outcomes were assessed by the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) at baseline and 16 weeks. Adverse effects and treatment discontinuation were recorded.
Results: A total of 102 patients completed the trial (Video: 52; Supervised: 50). Both groups showed significant improvement in ICIQ-SF scores (p < 0.001), with superior improvement in the Supervised group (p = 0.017). Adverse event rates were similar (p > 0.05), and no serious adverse events were reported.
Conclusion: PFMT combined with tolterodine improves urge incontinence symptoms. Supervised training yields greater benefit, though video-assisted PFMT remains a cost-effective and accessible alternative.

Keywords: urge incontinence, pelvic floor muscle training, randomized controlled trial, tolterodine

Abstract

Objective: This study aimed to compare the clinical efficacy of physiotherapist-supervised versus video-assisted pelvic floor muscle training (PFMT) combined with tolterodine therapy in women with urge incontinence.
Material and Methods: In this prospective randomized controlled trial, 120 women aged 18–60 years with urge incontinence were randomized into two groups. Both groups received tolterodine 4 mg/day. The Video group (n = 60) performed home-based Kegel exercises with instructional video support. The Supervised group (n = 60) attended twice-weekly physiotherapist-supervised sessions. Outcomes were assessed by the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) at baseline and 16 weeks. Adverse effects and treatment discontinuation were recorded.
Results: A total of 102 patients completed the trial (Video: 52; Supervised: 50). Both groups showed significant improvement in ICIQ-SF scores (p < 0.001), with superior improvement in the Supervised group (p = 0.017). Adverse event rates were similar (p > 0.05), and no serious adverse events were reported.
Conclusion: PFMT combined with tolterodine improves urge incontinence symptoms. Supervised training yields greater benefit, though video-assisted PFMT remains a cost-effective and accessible alternative.

Keywords: urge incontinence, pelvic floor muscle training, randomized controlled trial, tolterodine

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