Pelvic floor muscle training added to another active treatment versus the same active treatment alone for urinary incontinence in women

• Published in: Cochrane database of systematic reviews 2015-11, Vol.2015 (11), p.CD010551-CD010551
• Main Authors: Ayeleke, Reuben Olugbenga, Hay-Smith, E Jean C, Omar, Muhammad Imran
• Format: Article
• Language: English
• Subjects: Combined Modality Therapy - methods; Electric Stimulation Therapy; Exercise Therapy - methods; Female; Gynaecology; Hot Temperature - therapeutic use; Humans; Insurance medicine; Pelvic Floor; Pessaries; Quality of Life; Randomized Controlled Trials as Topic; Treatment Outcome; Urinary incontinence (including enuresis); Urinary Incontinence, Stress - therapy; Urinary Incontinence, Urge - therapy; Urology
• ISSN: 1469-493X
• DOI: 10.1002/14651858.CD010551.pub3

Pelvic floor muscle training (PFMT) is a first-line conservative treatment for urinary incontinence in women. Other active treatments include: physical therapies (e.g. vaginal cones); behavioural therapies (e.g. bladder training); electrical or magnetic stimulation; mechanical devices (e.g. continence pessaries); drug therapies (e.g. anticholinergics (solifenacin, oxybutynin, etc.) and duloxetine); and surgical interventions including sling procedures and colposuspension. This systematic review evaluated the effects of adding PFMT to any other active treatment for urinary incontinence in women To compare the effects of pelvic floor muscle training combined with another active treatment versus the same active treatment alone in the management of women with urinary incontinence. We searched the Cochrane Incontinence Group Specialised Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE in process, ClinicalTrials.gov, WHO ICTRP and handsearching of journals and conference proceedings (searched 5 May 2015), and CINAHL (January 1982 to 6 May 2015), and the reference lists of relevant articles. We included randomised or quasi-randomised trials with two or more arms, of women with clinical or urodynamic evidence of stress urinary incontinence, urgency urinary incontinence or mixed urinary incontinence. One arm of the trial included PFMT added to another active treatment; the other arm included the same active treatment alone. Two review authors independently assessed trials for eligibility and methodological quality and resolved any disagreement by discussion or consultation with a third party. We extracted and processed data in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. Other potential sources of bias we incorporated into the 'Risk of bias' tables were ethical approval, conflict of interest and funding source. Thirteen trials met the inclusion criteria, comprising women with stress urinary incontinence (SUI), urgency urinary incontinence (UUI) or mixed urinary incontinence (MUI); they compared PFMT added to another active treatment (585 women) with the same active treatment alone (579 women). The pre-specified comparisons were reported by single trials, except bladder training, which was reported by two trials, and electrical stimulation, which was reported by three trials. However, only two of the three trials reporting electrical stimulation could be p