Pelvic Floor Yoga for Women with Overactive Bladder-Wet: A Subgroup Analysis of a Multisite Randomized Trial

Introduction and Hypothesis Pelvic floor yoga has been proposed as a community-based therapeutic modality for disruptive overactive bladder (OAB) symptoms such as urgency urinary incontinence (UUI) and urinary frequency, but evidence of its efficacy is limited. We examined the efficacy of pelvic floor yoga versus nonspecific physical conditioning exercise for managing OAB-wet symptoms in women. Methods We present a prespecified subgroup analysis of women with OAB-wet in a multicenter trial involving randomization to 12 weeks of group instruction and self-directed practice of pelvic floor yoga techniques versus time-equivalent instruction and practice of skeletal muscle conditioning exercises. Linear mixed models examined changes in OAB symptoms over 6 and 12 weeks assessed by diary and the Urogenital Distress Inventory-6 (UDI-6). Results Among 140 women with OAB-wet (71 randomized to pelvic floor yoga, 69 to physical conditioning), mean baseline UUI frequency was 2.8 (± 1.9) episodes/day. Average UUI frequency decreased by 1.9 episodes/day in the yoga and 1.6 episodes/day in the physical conditioning group over 6 and 12 weeks (nonsignificant between-group difference of −0.3 episodes/day [95% CI −0.7, 0.2]). UDI-6 scores decreased by 10.3 points with yoga and 3.3 with physical conditioning, although neither within-group change was significant. The between-group difference was −7.1 [95% CI −12.2, −1.8]), favoring yoga. Modestly greater improvements in daytime voiding were observed with yoga (between-group difference −0.7 episodes/day [95% CI −1.4, −0.01]. Conclusions Women with OAB-wet symptoms reported improvement from both pelvic floor yoga and general physical conditioning exercise, with yoga showing modestly greater reductions in urinary distress and daytime voiding frequency.