Group Learning Achieves Decreased Incidents of Lower Urinary Symptoms

Inclusion criteria

• Female
• Aged 55 years or older
• Ability to understand, read and write English
• Stress, urgency, or mixed urgency and stress urinary incontinence (UI) (by self report)
• On the International Consultation on Incontinence Modular Questionnaire - Short Form (ICIQ UI-SF), frequency of leakage at least a 1 ("about once a week or less often") on item #1 and volume of urine loss at least a 2 ("a small amount") on item #2.
• Symptoms of three months duration or longer (on history)
• Passing score (i.e., categorized as "probably not demented") on the MiniCog Test
• Timed "Up and Go" Test (TUG) score of 20 seconds or less
• Willing to undergo vaginal/pelvic examination
• Signed informed consent form

Exclusion criteria

• History of renal, bladder, uterine, ovarian, urethral, anal or rectal cancer, radiation therapy to the pelvis for any cancer/malignancy, or any active cancer/malignancy (except skin cancer)
• Non-ambulatory (participant confined to bed or wheelchair)
• Persistent pelvic pain (defined as daily pelvic pain > 3 months)
• History of neurologic or end-stage diseases (e.g. cerebral vascular accident (CVA), Parkinson's disease, multiple sclerosis, epilepsy, spinal cord tumor or trauma, spina bifida, symptomatic herniated disc)
• Previous treatment or current participation in a research study for UI, including surgery or formal behavioral treatment (pelvic floor muscle training, biofeedback, pelvic floor electrical stimulation, percutaneous tibial nerve stimulation, sacral neuromodulation, botox or other periurethral injection)
• Currently taking urinary incontinence or overactive bladder medications
• History of other urinary conditions or procedures that may affect continence status (e.g. urethral diverticula, previous augmentation cystoplasty or artificial urinary sphincter; implanted nerve stimulators for urinary symptoms)
• Participation in any drug/device research study.
• Pelvic organ prolapse protruding past the introitus (at rest or persisting after strain)
• Evidence of urinary tract infection (UTI) by urine dipstick (leukocytes +1 or greater, nitrites +1 or greater, leukocytes alone (w/o nitrites) +2 or greater, or presence of hematuria > +1). Participants may be re-screened after treatment with antibiotics or if hematuria work-up is negative.
• History of 2 or more recurrent UTI's within the past year; more than one UTI within past 6 months
• Post void residual urine volume 150 cc or more.
• Unstable medical condition (as determined by site PI)

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