Higher Frequency of Care and Psychological Resilience Are Associated With Greater Urogenital Distress Inventory Change in Patients With Urinary Distress: A Retrospective Cohort Study

Purpose: To evaluate the impact of pelvic floor physical therapy (PFPT) on urinary incontinence by assessing PFPT dosage on patient outcomes using the Urogenital Distress Inventory-6 (UDI-6) scores. Methods: Patient data were derived from a patient outcomes registry. All patients completed an initial and final UDI-6 patient-reported outcome measure. Urogenital Distress Inventory-6 change from initial to final was calculated and used as the dependent variable in a multiple linear regression. The primary independent variables were dosage, defined as frequency of visits per week and total visit count across an episode of care. Additional predictor variables were included, encompassing demographics, initial disability levels, and mental and physical health capacity. Results: A total of 3436 women were included in the cohort, age 48 ± 17, and largely used commercial insurance (75%). The regression revealed higher initial UDI-6 scores, higher visit dosage, and better initial mental and physical health as significant predictors of improvement in urinary stress symptoms as measured by the UDI-6 ( r = .45, P < .001). The regression model explained 20% of the variance in UDI-6 change ( P < .001). Discussion: Greater improvements occur in patients with more severe urinary symptoms and better baseline physical and mental health status. Additionally, greater UDI-6 change was observed in patients who received higher dosage of PFPT. The results highlight the importance of individualized treatment planning and adequate visit frequency to achieve clinically meaningful outcomes. From a policy perspective, the study supports early access to care and flexible visit coverage to ensure equitable care delivery.