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Vol. 23. Issue 2.
Pages 77-186 (01 March 2019)
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Vol. 23. Issue 2.
Pages 77-186 (01 March 2019)
SYSTEMATIC REVIEW
DOI: 10.1016/j.bjpt.2019.01.002
Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: a cochrane systematic review abridged republication
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Licia P. Cacciaria, Chantale Dumoulina,b,
Corresponding author
chantal.dumoulin@umontreal.ca

Corresponding author at: School of rehabilitation, Faculty of medicine, University of Montreal, Montréal, Québec, Canada H3W 1W5.
, E. Jean Hay-Smithc
a Faculty of Medicine, University of Montréal, Research Center of the Institut Universitaire de Gériatrie, Montreal, QC, Canada
b Canadian Research Chair in Urogynecological Health and Aging, Montreal, QC, Canada
c Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand
Highlights

  • Women with stress UI were eight times more likely to report cure after PFMT.

  • Women with combined UI types were five times more likely to report cure after PFMT.

  • PFMT improves symptoms and QoL in women with stress, urge and combined UI types.

  • Results support the recommendation of PFMT as first-line treatment for UI in women.

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Table 1. Summary of findings for women with stress urinary incontinence.
Table 2. Summary of findings for women with combined urinary incontinence types.
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Abstract
Background

Pelvic floor muscle training is the most commonly used physical therapy treatment for women with urinary incontinence.

Objectives

To assess the effects of Pelvic floor muscle training for women with urinary incontinence in comparison to a control treatment and to summarize relevant economic findings.

Methods

Cochrane Incontinence Group Specialized Register (February 12, 2018). Selection criteria: Randomized or quasi-randomized trials in women with stress, urgency or mixed urinary incontinence (symptoms, signs, or urodynamic). Data collection and analysis: Trials were independently assessed by at least two reviewers authors and subgrouped by urinary incontinence type. Quality of evidence was assessed by adopting the Grading of Recommendations, Assessment, Development and Evaluation approach.

Results

The review included thirty-one trials involving 1817 women from 14 countries. Overall, trials were small to moderate size, and many were at moderate risk of bias. There was considerable variation in the intervention's content and duration. Based on data available, we can be confident that Pelvic floor muscle training can cure or improve symptoms of stress and all other types of urinary incontinence. It may reduce the number of leakage episodes and the quantity of leakage, while improving reported symptoms and quality of life. Women were more satisfied with Pelvic floor muscle training, while those in control groups were more likely to seek further treatment. Long-term effectiveness and cost-effectiveness of Pelvic floor muscle training needs to be further researched.

Conclusions

The addition of ten new trials did not change the essential findings of the earlier review, suggesting that Pelvic floor muscle training could be included in first-line conservative management of women with urinary incontinence.

Keywords:
Pelvic floor muscle training
Urinary incontinence
Women

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