Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: a cochrane systematic review abridged republication

Abstract

Background: Pelvic floor muscle training is the most commonly used physical therapy treatment for women with urinary incontinence.

Objectives: To assess the effects of Pelvic floor muscle training for women with urinary incontinence in comparison to a control treatment and to summarize relevant economic findings.

Methods: Cochrane Incontinence Group Specialized Register (February 12, 2018).

Selection criteria: Randomized or quasi-randomized trials in women with stress, urgency or mixed urinary incontinence (symptoms, signs, or urodynamic).

Data collection and analysis: Trials were independently assessed by at least two reviewers authors and subgrouped by urinary incontinence type. Quality of evidence was assessed by adopting the Grading of Recommendations, Assessment, Development and Evaluation approach.

Results: The review included thirty-one trials involving 1817 women from 14 countries. Overall, trials were small to moderate size, and many were at moderate risk of bias. There was considerable variation in the intervention's content and duration. Based on data available, we can be confident that Pelvic floor muscle training can cure or improve symptoms of stress and all other types of urinary incontinence. It may reduce the number of leakage episodes and the quantity of leakage, while improving reported symptoms and quality of life. Women were more satisfied with Pelvic floor muscle training, while those in control groups were more likely to seek further treatment. Long-term effectiveness and cost-effectiveness of Pelvic floor muscle training needs to be further researched.

Conclusions: The addition of ten new trials did not change the essential findings of the earlier review, suggesting that Pelvic floor muscle training could be included in first-line conservative management of women with urinary incontinence.

Keywords: Pelvic floor muscle training; Urinary incontinence; Women.

Copyright © 2019 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Figures

Figure 1

PRISMA study flow diagram.

Figure 2

Summary of risk of bias analysis. Low risk in green (+), unclear risk in yellow (?), high risk in red (−).

Figure 3

Forest Plot for cure (top) and cure and improvement (bottom) comparing pelvic floor muscle training (PFMT) versus no treatment, placebo or control.