Efficacy of pelvic floor physiotherapy intervention for stress urinary incontinence in postmenopausal women: systematic review

• Published in: Archives of gynecology and obstetrics 2023-07, Vol.308 (1), p.13-24
• Main Authors: Malinauskas, Ana Paula, Bressan, Elaine Fernandes Macedo, de Melo, Andrea Maria Zaher Rosa Pereira, Brasil, Cristina Aires, Lordêlo, Patricia, Torelli, Luiza
• Format: Article
• Language: English
• Subjects: Aged; Clinical trials; CRD; CRD42021255062; Endocrinology; Exercise Therapy - methods; Female; Gynecology; Human Genetics; Humans; Medicine; Medicine & Public Health; Middle Aged; Obstetrics/Perinatology/Midwifery; Pelvic Floor; Pelvis; Physical therapy; Physical Therapy Modalities; Postmenopause; Review; Systematic review; Treatment Outcome; Urinary incontinence; Urinary Incontinence, Stress - therapy
• ISSN: 1432-0711; 0932-0067; 1432-0711
• DOI: 10.1007/s00404-022-06693-z

Introduction and hypothesis Our objective was to evaluate the effectiveness of pelvic floor physiotherapy interventions for stress urinary incontinence (SUI) in postmenopausal women. Methods Searches were performed in MEDLINE/PubMed, PEDro, Cochrane Library Registry and LILACS databases until October 2021. Only randomized controlled trials (RCTs) which had physiotherapy interventions as primary outcome were included. There were no restrictions on the year of publication or language. Qualitative methodology was evaluated using the PEDro scale. Results After applying inclusion/exclusion criteria and quality control, 6 randomized controlled trials were included in this systematic review. Methodological quality of trials varied from 5 to 8 (out of 10 possible points in PEDro scale score). Sample consisted of 715 subjects; mean age was between 51.6 and 66.3 years; SUI severity scale ranged from small to severe. Interventions were pelvic floor muscle training (PFMT); vaginal cone (VC); biofeedback (BF); electrical muscle stimulation (EMS); radiofrequency (RF) and electroacupuncture (EA). Pelvic floor physiotherapy was effective in all studies, however, meta-analysis was considered irrelevant due to the heterogeneity of the reported interventions. Conclusion There is not a literature consensus about the most effective pelvic floor physiotherapy intervention applied to stress urinary incontinence in postmenopausal women. It seems appropriate to state that further randomized controlled clinical trials should be done, due to the limited number of studies and heterogeneity of physiotherapeutic interventions applied to date. Trial registration This systematic review is registered in PROSPERO in the trial registration CRD42021255062.