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. 2023 Sep;49(5):293-306.
doi: 10.5152/tud.2023.23018.

Physiotherapy in Patients with Stress Urinary Incontinence: A Systematic Review and Meta-analysis

Fariba Ghaderi  1 , Ghazal Kharaji  2 , Sakineh Hajebrahimi  3 , Fariba Pashazadeh  3 , Bary Berghmans  4 , Hanieh Salehi Pourmehr  5
Affiliations

Physiotherapy in Patients with Stress Urinary Incontinence: A Systematic Review and Meta-analysis

Fariba Ghaderi et al. Urol Res Pract. 2023 Sep.

Abstract

Physiotherapy is the most commonly used treatment for stress urinary incontinence including pelvic floor muscle training, biofeedback, and electrical stimulation. This systematic review evaluated the effects of physiotherapy in patients with stress urinary incontinence compared with no treatment, placebo, sham, surgery, or other inactive control treatments. MEDLINE (via PubMed), The Cochrane Library (CENTRAL), Embase, Scopus, Web of Science, PEDro, and Trip Database were explored using applicable vocabularies for all English and Persian language investigations released from inception to January 2021. On one side, trials including physiotherapy of pelvic floor muscle training, biofeedback, and electrical stimulation and on the other, either no treatment, placebo, sham, surgery, or other inactive control treatments were included. Studies were assessed for appropriateness and methodological excellence. Two authors extracted data. Disagreements were resolved by a third opinion. Data were processed as described in the Joanna Briggs Institute Handbook. Twenty-nine trials with 2601 participants were found, but only 16 were included because of data heterogeneity. The results showed that physiotherapy interventions are better than no treatment in terms of urine leakage, but no difference was found for urinary incontinence severity. Also, physiotherapy showed favorable results over comparison groups for International Consultation on Incontinence Questionnaire, pad test, pelvic floor muscle function, and improvement outcomes. This systematic review supports the widespread use of pelvic physiotherapy as the first-line treatment for adult patients with stress urinary incontinence.

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Conflict of interest statement

Declaration of Interests: The authors have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.
Search results, study selection, and inclusion process.
Figure 2.
Figure 2.
Difference between physiotherapy interventions and no treatment according to the ICIQ-SF. ICIQ-SF, International Consultation on Incontinence Questionnaire–Short Form.
Figure 3.
Figure 3.
Difference between physiotherapy interventions and no treatment according to pad test.
Figure 4.
Figure 4.
Difference in urinary incontinence severity according to the ICIQ-SF between physiotherapy and comparison groups. ICIQ-SF, Incontinence Impact Questionnaire–Short Form.
Figure 5.
Figure 5.
Difference in urinary incontinence severity according to pad test between physiotherapy and comparison groups.
Figure 6.
Figure 6.
Difference in PFM function according to manometry between physiotherapy and comparison groups. PFM, pelvic floor muscle.
Figure 7.
Figure 7.
Difference in improvement between physiotherapy and comparison groups.
See this image and copyright information in PMC

References

    1. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-Committee of the International Continence Society. Am J Obstet Gynecol. 2002;187(1):116 126. (10.1067/mob.2002.125704) - DOI - PubMed
    1. Markland AD, Richter HE, Fwu CW, Eggers P, Kusek JW. Prevalence and trends of urinary incontinence in adults in the United States, 2001 to 2008. J Urol. 2011;186(2):589 593. (10.1016/j.juro.2011.03.114) - DOI - PMC - PubMed
    1. Mostafaei H, Sadeghi-Bazargani H, Hajebrahimi S, et al. Prevalence of female urinary incontinence in the developing world: a systematic review and meta-analysis-A report from the Developing World Committee of the International Continence Society and Iranian Research Center for evidence based medicine. Neurourol Urodyn. 2020;39(4):1063 1086. (10.1002/nau.24342) - DOI - PubMed
    1. Senra C, Pereira MG. Quality of life in women with urinary incontinence. Rev Assoc Med Bras (1992). 2015;61(2):178 183. (10.1590/1806-9282.61.02.178) - DOI - PubMed
    1. Babic U, Santric-Milicevic M, Terzic Z, et al. Impact of voiding and incontinence symptoms on health-related life quality in Serbian male population. Urol J. 2015;12(3):2196 2203. - PubMed