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.
