Comparing the efficacy of electrical stimulation (ES) and pelvic floor muscles training (PFMT) on urinary incontinence (UI) symptoms, quality of life and sexual function on women with stress UI. Also, to analyze the influence of supervised and non-supervised PFMT.
Systematic review of randomized trials involving adult women with stress UI. Studies' review was performed by two independent researchers on PubMed, EMBASE, PEDro, Cochrane Library, LILACS. The PEDro scale was used to evaluate the quality of included studies. The certainty of evidence was analyzed by the GRADE. A meta-analysis was performed.
Seven studies comprising 411 women with stress UI were included. Methodological quality ranged from 3 to 8 points. Treatment sessions varied from 5 to 45 min (PMFT) and 15 to 30 min (ES), from 4 weeks to 6 months. Studies varied regarding the type of electrical current and its characteristics. With very low certainty of evidence and severe risk of methodological bias, the meta-analysis showed that ES is not superior to supervised or unsupervised PFMT for any outcome.
ES is not superior to PFMT for reducing urinary leakage or improving quality of life in women with stress UI.
Electrical stimulation and pelvic floor muscle training are widely used interventions in the treatment of urinary incontinenceRecommendations on the difference in the efficacy of electrical stimulation and pelvic floor muscles training in reducing UI symptoms in adult women need to be very cautious; up to now there is no evidence that show superiority between pelvic floor muscle training or electrical stimulationWe suggest that future research on this field be concerned regarding study design, methodologic quality and adequate number of subjects, since the studies included in this systematic review were heterogeneous regarding variables as main outcome and also the protocols both for the pelvic floor muscles training and the electrical stimulation.
Disability and rehabilitation. 2024 Oct 28 [Epub ahead of print]
A C Lunardi, G C Foltran, D F Carro, L T Y Silveira, J M Haddad, E A G Ferreira
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil., Divisao de Clinica Obstetrica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.