A Group-Based Therapeutic Yoga Intervention for Urinary Incontinence in Ambulatory Older Women

Inclusion Criteria:

- Women aged 45 years or older who report urinary incontinence starting at least 3
months prior to screening

- Self-report an average of at least one incontinence episode per day on a validated
voiding diary

- Self-report urgency-predominant (i.e., at least half of incontinence episodes being
urgency-type), stress-predominant (i.e., at least half of episodes being stress-type),
or mixed-type (i.e., an equal number of stress- and urgency-type episodes)
incontinence on the screening voiding diary

- Willing to refrain from initiating medical treatments that may affect their
incontinence or voiding pattern during the study intervention period

Exclusion Criteria:

- Current participation in organized yoga classes or workshops, or any prior organized
yoga training directed specifically at improving incontinence

- Current participation in organized physical conditioning classes involving muscle
strengthening exercises (e.g., Pilates)

- Current urinary tract infection or hematuria detected by urinalysis at screening visit
(women can re-present after evaluation and treatment through their usual care)

- Currently pregnant (by self-report or screening urine pregnancy test), gave birth
within the past 3 months, or planning pregnancy during the study period

- Report use of medical devices (i.e. pessary) for incontinence within the past month
(participants may stop use of device and re-present for study)

- Report use of bladder botox, electrostimulation, formal bladder training, or formal
pelvic floor exercise training (with certified practitioners) in the past 3 months

- Report any history of prior anti-incontinence or urethral surgery (not including
urethral dilation), pelvic cancer, or pelvic irradiation

- Report other surgery to the pelvis (hysterectomy, oophorectomy, vaginal surgery,
bladder surgery, colon surgery) within the past 3 months

- Unable to walk 2 blocks on level ground without assistance (functional capacity < 4
metabolic equivalents)

- Unable to get up from a supine to a standing position without assistance (assessed
during the screening visit)

- Report history of interstitial cystitis, bladder or rectal fistula, or congenital
defect causing urinary incontinence

- Report incontinence caused by a major neurologic conditions such as multiple
sclerosis, spinal cord injury, or Parkinson's disease

- Report use of medications with strong effects on urination (anticholinergic bladder
medications, beta-3 agonists, tricyclic antidepressants, mirabegron, loop diuretics)
within the past month

- Report starting, stopping, or changing the dose of a medication with the potential to
affect anxiety or depression symptoms (i.e., selective serotonin reuptake inhibitors,
anxiolytics/sedatives, antipsychotics) within the past 1 month, or plans to start,
stop, or change to dose of such a medication during the study period

- Participation in another research study that involves investigational drugs or devices
that could potentially confound the results of this study

- Unable to understand study procedures, complete study interviews, or and provide
informed consent in English

- Report conditions that, in the judgment of the investigators, render potential
participants unlikely to follow the protocol, including plans to move, substance
abuse, significant psychiatric problems, or dementia