Article type
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Abstract
Objective: To assess the efficacy of prevention and non-surgical treatment of stress urinary incontinence (SUI), a systematic review of randomized clinical trials (RCTs) was undertaken.
Methods: A computer aided literature search for RCTs investigating the efficacy of pelvic floor muscle exercises (PFME) alone or with additional interventions was performed. The methodological quality of the RCTs was assessed by using criteria based on generally accepted principles of intervention research. Conclusions on the efficacy of the interventions are based on the quality and outcome of the studies with respect to levels of scientific evidence.
Results: A total of 49/171 publications were considered potentially relevant to the research question. Further analysis allowed 22 RCTs to be included in the systematic review. Twenty investigated non-surgical therapy and 2 prevention. The mean methodological quality of these trials was moderate (range 3 - 8.5; median 5.5; maximum score 10). Eleven RCTs were of sufficient methodological quality for further analysis.
Discussion: Based on the levels of evidence, there is strong evidence that PFME is effective in reducing the symptoms of SUI. There is no evidence that biofeedback as an adjunct to PFME is more effective than PFME alone. There is limited evidence that intravaginal electrostimulation (IVE) is superior to sham IVE, but moderate evidence that IVE alone is no more effective than PFME alone. More research is needed to evaluate the effects of non-surgical therapies used to treat and prevent SUI.
Methods: A computer aided literature search for RCTs investigating the efficacy of pelvic floor muscle exercises (PFME) alone or with additional interventions was performed. The methodological quality of the RCTs was assessed by using criteria based on generally accepted principles of intervention research. Conclusions on the efficacy of the interventions are based on the quality and outcome of the studies with respect to levels of scientific evidence.
Results: A total of 49/171 publications were considered potentially relevant to the research question. Further analysis allowed 22 RCTs to be included in the systematic review. Twenty investigated non-surgical therapy and 2 prevention. The mean methodological quality of these trials was moderate (range 3 - 8.5; median 5.5; maximum score 10). Eleven RCTs were of sufficient methodological quality for further analysis.
Discussion: Based on the levels of evidence, there is strong evidence that PFME is effective in reducing the symptoms of SUI. There is no evidence that biofeedback as an adjunct to PFME is more effective than PFME alone. There is limited evidence that intravaginal electrostimulation (IVE) is superior to sham IVE, but moderate evidence that IVE alone is no more effective than PFME alone. More research is needed to evaluate the effects of non-surgical therapies used to treat and prevent SUI.