Paper 8: Hypnotherapy or Pharmacotherapy for Urgency Urinary Incontinence Treatment in Women. The Hyp-hOP Randomized Clinical Trial

Thursday, October 11, 2018

03:20 PM – 03:30 PM

Hyatt Regency Chicago – Riverside East

Objective: To determine whether hypnotherapy effectively treats urgency urinary incontinence (UUI) compared to pharmacotherapy.

Methods: This investigator-masked trial randomized women with non-neurogenic UUI to hypnotherapy or medication, enrolling those with 23 UUI episodes/week. Primary outcome: 3-day diary UUI episodes. Hypnotic susceptibility testing categorized participants into low, medium & high susceptibility. Hypnotherapy group received 8 weekly hypnotherapy sessions, 1 optional “booster” session & audio-recordings. Medication group received 1 medication counseling session, 8 weekly follow-up sessions & extended release anti-muscarinics x 1 year. Follow-up occurred at 2, 6 & 12 months. Multivariable analysis compared groups with respect to UUI, P<0.05.

Results: 152 women were randomized (74 hypnotherapy/78 medications); 142 completed 2-month & 140 completed 12- month follow-up (Table 1). Groups did not differ in any characteristics, including age (57.6±12.8, 59.5±10.3 years, P=0.34) & hypnotic susceptibility (P=0.46). Most had high (N=101) or medium (N=31) susceptibility, few had low (N=10). Unadjusted between group comparisons showed no UUI differences at baseline & follow-up; both groups improved (Table 1).

Regression analysis revealed hypnotic susceptibility & baseline UUI influenced follow-up UUI. Due to a 3-way interaction (groupxtimexhypnotic susceptibility), least squares means best described UUI episodes. At 2 months, there were no UUI differences between groups. At 6 months, medium hypnotic susceptibility participants treated with hypnotherapy had fewer UUI episodes compared to medication; 1.2 (0.6-2.5) vs. 3.3 (1.8-6.0), ratio 0.36, 95% CI 0.14-0.94. At 12 months, high hypnotic susceptibility participants treated with hypnotherapy had fewer UUI episodes compared to medication; 2.1 (1.5-3.7) vs. 3.7 (2.5-5.6), ratio 0.56, 95% CI 0.32-0.98] (Fig. 1).

Conclusions: Hypnotherapy & medication both effectively treated UUI at 2–12-month follow-up, with median UUI decreasing 2 85%. In those with medium-high hypnotic susceptibility, hypnotherapy was superior to medication at longer follow-up, offering a durable alternative therapy for UUI.

Authors

Yuko M. Komesu, M.D.

University of New Mexico

Ronald Schrader, PhD

University of New Mexico

Rebecca G. Rogers, MD

University of New Mexico

Robert Sapien, MD

University of New Mexico

Loren H Ketai, MD

University of New Mexico

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Paper 8: Hypnotherapy or Pharmacotherapy for Urgency Urinary Incontinence Treatment in Women. The Hyp-hOP Randomized Clinical Trial

Authors