Bladder Training Supported by Alarm Reminders and Distraction Techniques for Mixed Urinary Incontinence

This randomized controlled trial evaluated the effectiveness of bladder training supported by smartphone alarm reminders and distraction techniques in women with persistent mixed urinary incontinence who continued to experience symptoms despite completing pelvic floor muscle exercise (PFME) therapy at least six months previously. Participants were stratified according to age, educational level, body mass index, mode of delivery, and baseline urinary incontinence severity before randomization to either an intervention group or a control group. The intervention group received an 8-week bladder training program supported by alarm reminders and distraction techniques, while the control group received routine care. Outcomes included urinary incontinence severity, symptom distress, quality of life, urinary incontinence episodes, voiding intervals, treatment satisfaction, and adherence to bladder training.

Inclusion Criteria: Women aged 18-65 years. * Physician-diagnosed mixed urinary incontinence. * Previously received pelvic floor muscle exercise (PFME) as the sole treatment for urinary incontinence. * Completed PFME therapy at least six months before enrollment. * Continued to experience urinary incontinence symptoms after completion of PFME therapy. * Owned and were able to use a smartphone. * Were not receiving any active treatment for urinary incontinence during the study period. * Provided written informed consent. Exclusion Criteria: * Urinary tract infection. * Neurological disorders affecting bladder function. * Pregnancy. * Active treatment for urinary incontinence. * Previous bladder training. * Previous biofeedback therapy. * Previous magnetic chair therapy. * Cognitive impairment. * Any medical condition that could interfere with participation or completion of the study.