Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women : a short version Cochrane systematic review with meta-analysis

摘要

BackgroundPelvic floor muscle training (PFMT) is a commonly used physical therapy for women with urinary incontinence (UI).ObjectivesTo determine the effects of PFMT for women with UI in comparison to no treatment, placebo or other inactive control treatments.Search MethodsCochrane Incontinence Group Specialized Register, (searched 15 April 2013).Selection CriteriaRandomized or quasi-randomized trials in women with stress, urgency or mixed UI (based on symptoms, signs, or urodynamics).Data Collection and AnalysisAt least two independent review authors carried out trial screening, selection, risk of bias assessment and data abstraction. Trials were subgrouped by UI diagnosis. The quality of evidence was assessed by adopting the (GRADE) approach.ResultsTwenty-one trials (1281 women) were included; 18 trials (1051 women) contributed data to the meta-analysis. In women with stress UI, there was high quality evidence that PFMT is associated with cure (RR 8.38; 95% CI 3.68 to 19.07) and moderate quality evidence of cure or improvement (RR 17.33; 95% CI 4.31 to 69.64). In women with any type of UI, there was also moderate quality evidence that PFMT is associated with cure (RR 5.5; 95% CI 2.87–10.52), or cure and improvement (RR 2.39; 95% CI 1.64–3.47).ConclusionsThe addition of seven new trials did not change the essential findings of the earlier version of this review. In this iteration, using the GRADE quality criteria strengthened the recommendations for PFMT and a wider range of secondary outcomes (also generally in favor of PFMT) were reported.