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

There is insufficient evidence of the effectiveness of adding pelvic floor muscle training to other active treatment when compared with the same active treatment alone for stress, urgency or mixed urinary incontinence in women.

Comment: The quality of evidence is downgraded by study quality (inadequate allocation concealment, no blinding, selective reporting, conflict of interests) and by imprecise results (limited study size for each comparison).

Summary

A Cochrane review included 11 studies with a total of 984 women with stress urinary incontinence (SUI), urgency urinary incontinence (UUI) or mixed urinary incontinence (MUI) comparing pelvic floor muscle training (PFMT) added to another active treatment with the same active treatment alone. The majority of the trials did not report the primary outcomes cure/improvement or quality of life. There was moderate-quality evidence from a single trial investigating women with SUI, UUI or MUI that a higher proportion of women who received a combination of PFMT and heat and steam generating sheet reported cure compared to those who received the sheet alone: 19/37 (51%) versus 8/37 (22%) with a risk ratio (RR) of 2.38, 95% confidence interval (CI) 1.19 to 4.73). More women reported cure or improvement of incontinence in a low quality trial comparing PFMT added to vaginal cones to vaginal cones alone. Only one trial evaluating PFMT when added to drug therapy provided information about adverse events (RR 0.84, 95% CI 0.45 to 1.60; very low-quality evidence). With regard to condition-specific quality of life, there were no statistically significant differences between women (with SUI, UUI or MUI) who received PFMT added to bladder training and those who received bladder training alone at three months after treatment either on the Incontinence Impact Questionnaire-Revised scale (mean difference (MD) -5.90, 95% CI -35.53 to 23.73) or on the Urogenital Distress Inventory scale (MD -18.90, 95% CI -37.92 to 0.12). A similar pattern of results was observed between women with SUI who received PFMT plus either a continence pessary or duloxetine and those who received the continence pessary or duloxetine alone.

Clinical comments

Date of latest search: 28 February 2013

Ədəbiyyat

1. Ayeleke RO, Hay-Smith EJ, Omar MI. Pelvic floor muscle training added to another active treatment versus the same active treatment alone for urinary incontinence in women. Cochrane Database Syst Rev 2013;(11):CD010551.