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Comparative Study
. 2024 Nov 6;14(1):26957.
doi: 10.1038/s41598-024-78358-7.

Comparison of nonimplantable electrical stimulation in women with urinary incontinence: a systematic review and network meta-analysis of randomized controlled trials

Tzu-Yin Yu  1   2 , Chin-Yin Yu  3 , Reuben Escorpizo  4   5 , Tsan-Hon Liou  3   6 , Chin-Wen Wu #  3   6 , Hung-Chou Chen #  7   8
Affiliations
Comparative Study

Comparison of nonimplantable electrical stimulation in women with urinary incontinence: a systematic review and network meta-analysis of randomized controlled trials

Tzu-Yin Yu et al. Sci Rep. .

Abstract

This study examined the effectiveness of various electrical stimulation methods in alleviating symptoms and enhancing the quality of life for women with urinary incontinence. We conducted a systematic search of PubMed, Cochrane Library, PEDro, EMBASE, and ClinicalTrials.gov from inception to August 2024. Randomized controlled trials (RCTs) that meet following criteria were included, urinary continence in women, using various electric stimulation treatments and evaluated outcomes related to symptoms, quality of life. Thirty RCTs were subjected to risk of bias assessment, certainty of evidence, and network meta-analysis. Statistical analysis was performed using a random-effects model, with continuous variables expressed as standardized mean difference (SMD) and 95% confidence interval (CI). Percutaneous tibial stimulation (SMD - 1.86, 95% CI - 2.77 to - 0.96) and intravaginal stimulation (SMD - 0.97, 95% CI - 1.55 to - 0.38) significantly reduced symptom severity. Additionally, percutaneous tibial, intravaginal, transcutaneous tibial, and trans-sacral stimulations improved quality of life. Percutaneous tibial stimulation was the most effective, followed by intravaginal stimulation. Despite moderate to low confidence in the evidence, large-scale RCTs are needed to evaluate long-term benefits of these treatment.

Keywords: Electric stimulation; Network meta-analysis; Systematic review; Urinary incontinence..

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram for study selection strategy.
Fig. 2
Fig. 2
Network plot of studies examining (a) symptom severity and (b) quality of life. Node size (blue circle) is proportional to the number of trials evaluating that intervention, and yellow lines indicate the number of comparisons between each treatment. EA, electroacupuncture; IVS, intravaginal stimulation; PFS, pelvic floor stimulation; PLA, control/placebo group; PTS, percutaneous tibial stimulation; TSS, trans-sacral stimulation; TTS, transcutaneous tibial stimulation.
Fig. 3
Fig. 3
Forest plot of (a) symptom severity and (b) quality of life. EA, electroacupuncture; IVS, intravaginal stimulation; PFS, pelvic floor stimulation; PLA, control/placebo group; PTS, percutaneous tibial stimulation; TSS, trans-sacral stimulation; TTS, transcutaneous tibial stimulation.
Fig. 4
Fig. 4
Distribution of probability rankings for each electrical approach in terms of (a) symptom severity and (b) quality of life. EA, electroacupuncture; IVS, intravaginal stimulation; PFS, pelvic floor stimulation; PLA, control/placebo group; PTS, percutaneous tibial stimulation; TSS, trans-sacral stimulation; TTS, transcutaneous tibial stimulation.
See this image and copyright information in PMC

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