Urotherapy

Urotherapy is a non-pharmacological, first-line approach to managing lower urinary tract symptoms (LUTS). It aims to improve bladder function and urinary habits through education, behavioral strategies, and lifestyle modifications. It is widely used in pediatric patients but is also applied to adults with conditions such as overactive bladder, stress and urge incontinence, frequency, and nocturia.

Core components include bladder diaries to monitor patterns; education about normal bladder function; timed voiding and bladder training to increase capacity; urge suppression techniques; fluid management to regulate intake and avoid bladder irritants; constipation treatment; pelvic floor muscle training, sometimes with biofeedback; and referrals for physical therapy.

Delivery and settings: Usually provided by urotherapists, continence nurses, or physical therapists with specialization in pelvic floor disorders. Sessions may be individual or combined with other treatments. It is typically non-invasive and practiced alongside other therapies, including medications if indicated.

Effectiveness and limitations: Urotherapy can reduce urinary urgency, frequency, and incontinence and improve quality of life, particularly in children with enuresis and daytime incontinence and in select adults with LUTS. Outcomes depend on adherence and the absence of underlying pathologies such as infection or obstruction. It may be insufficient alone for some conditions and may require modification or combination with pharmacotherapy or other interventions.