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The Somatic Connection  |   October 2013
Systematic Review of OMTh for Lower Urinary Tract Symptoms in Women Shows Benefit
Author Affiliations
  • Hollis H. King, DO, PhD
    University of Wisconsin School of Medicine and Public Health, Madison
Article Information
The Somatic Connection   |   October 2013
Systematic Review of OMTh for Lower Urinary Tract Symptoms in Women Shows Benefit
The Journal of the American Osteopathic Association, October 2013, Vol. 113, 794. doi:10.7556/jaoa.2013.052
The Journal of the American Osteopathic Association, October 2013, Vol. 113, 794. doi:10.7556/jaoa.2013.052
Franke H, Hoesele K. Osteopathic manipulative treatment (OMT) for lower urinary tract symptoms (LUTS) in women [published online June 17, 2012]. J Bodyw Mov Ther. 2013;17(1):11-18. doi:10.1016/j.jbmt.2012.05.001.  
In a systematic review, German authors Franke and Hoesele assessed studies on osteopathic manipulative therapy (OMTh) for women with lower urinary tract symptoms (LUTS). All 5 of the studies included in the systematic review were published in German, making them difficult to critique in great detail. My clinical experience in treating women with LUTS, however, has been positive and consistent with the details reported by the authors. Also, I have attended research conferences in Germany and other parts of Europe, where I interacted with some of the researchers cited in this study and with other well-published German osteopathic researchers. My interactions with these individuals lead me to feel confident in the quality of the research reported in this systematic review. 
Each study had an experimental group of 24 to 45 participants who received OMTh and a control group of 23 to 45 participants who received either no treatment or pelvic floor muscle training. The OMTh was fairly consistent between studies and included visceral techniques to the bladder and pelvic diaphragm release. Techniques directed at the pelvis and axial skeleton included muscle energy, counterstrain, cranial, and balanced ligamentous tension; no techniques were found to be more effective than the others. The number of OMTh administrations per study ranged from 3 to 5 during a period ranging from 4 to 12 weeks. 
All 5 studies had statistically significant outcomes based on standard LUTS questionnaires used in urologic research. Using meta-analysis, the authors found statistically significant improvements in women in the OMTh groups compared with women in the no-treatment groups. Improvement in women in the OMTh groups was similar to that of women in the pelvic floor muscle training groups. 
The authors concluded that although further research is needed on which OMTh techniques might be most beneficial, OMTh should be considered in the treatment of patients with LUTS. Use of OMTh and osteopathic manipulative treatment for LUTS has much to offer in women's health, including prenatal care and pelvic pain management.