• Alison J Huang, Margaret Chesney, Michael Schembri, Harini Raghunathan, Eric Vittinghoff, Wendy Berry Mendes, Sarah Pawlowsky, and Leslee L Subak.
• Department of Medicine, Department of Urology, and Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California (A.J.H.).
• Ann. Intern. Med. 2024 Oct 1; 177 (10): 133913491339-1349.

BackgroundPelvic floor yoga has been recommended as a complementary treatment strategy for urinary incontinence (UI) in women, but evidence of its efficacy is lacking.ObjectiveTo evaluate the effects of a therapeutic pelvic floor yoga program versus a nonspecific physical conditioning program on UI in women.DesignRandomized trial. (ClinicalTrials.gov: NCT03672461).SettingThree study sites in California, United States.ParticipantsAmbulatory women aged 45 years or older reporting daily urgency-, stress-, or mixed-type UI.InterventionTwelve-week program of twice-weekly group instruction and once-weekly self-directed practice of pelvic floor-specific Hatha yoga techniques (pelvic yoga) versus equivalent-time instruction and practice of general skeletal muscle stretching and strengthening exercises (physical conditioning).MeasurementsTotal and type-specific UI frequency assessed by 3-day voiding diaries.ResultsAmong the 240 randomly assigned women (age range, 45 to 90 years), mean baseline UI frequency was 3.4 episodes per day (SD, 2.2), including 1.9 urgency-type episodes per day (SD, 1.9) and 1.4 stress-type episodes per day (SD, 1.7). Over a 12-week time period, total UI frequency (primary outcome) decreased by an average of 2.3 episodes per day with pelvic yoga and 1.9 episodes per day with physical conditioning (between-group difference of -0.3 episodes per day [95% CI, -0.7 to 0.0]). Urgency-type UI frequency decreased by 1.2 episodes per day in the pelvic yoga group and 1.0 episode per day in the physical conditioning group (between-group difference of -0.3 episodes per day [CI, -0.5 to 0.0]). Reductions in stress-type UI frequency did not differ between groups (-0.1 episodes per day [CI, -0.3 to 0.3]).LimitationNo comparison to no treatment or other clinical UI treatments; conversion to videoconference-based intervention instruction during the COVID-19 pandemic.ConclusionA 12-week pelvic yoga program was not superior to a general muscle stretching and strengthening program in reducing clinically important UI in midlife and older women with daily UI.Primary Funding SourceNational Institutes of Health.

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