Conservative treatments for women with stress urinary incontinence: a systematic review and network meta-analysis

ObjectiveThis study aimed to compare the effectiveness of various conservative treatment strategies for women with stress urinary incontinence.MethodsA comprehensive search of PubMed, Web of Science, Embase, and the Cochrane Library was conducted from their inception through March 2024, without rest...

Full description

Saved in:
Bibliographic Details
Main Authors: Mengzhen Li, Kexin Qiu, Haoran Guo, Mengsi Fan, Li Yan
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2024.1517962/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850138792714829824
author Mengzhen Li
Mengzhen Li
Kexin Qiu
Kexin Qiu
Haoran Guo
Haoran Guo
Mengsi Fan
Mengsi Fan
Li Yan
Li Yan
author_facet Mengzhen Li
Mengzhen Li
Kexin Qiu
Kexin Qiu
Haoran Guo
Haoran Guo
Mengsi Fan
Mengsi Fan
Li Yan
Li Yan
author_sort Mengzhen Li
collection DOAJ
description ObjectiveThis study aimed to compare the effectiveness of various conservative treatment strategies for women with stress urinary incontinence.MethodsA comprehensive search of PubMed, Web of Science, Embase, and the Cochrane Library was conducted from their inception through March 2024, without restrictions on language or location. Randomized controlled trials (RCTs) comparing the efficacy of conservative treatments for stress urinary incontinence, using short-term pad test or the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) score as outcome measures, were included. We conducted a network meta-analysis using a random-effects model to compare the effectiveness of different conservative treatment strategies, employing prediction interval plots and league tables, and ranked them according to the surface under the cumulative ranking curve (SUCRA). The quality of the included studies was assessed following the Cochrane Handbook for Systematic Reviews of Interventions.ResultsA total of 31 RCTs involving 1,900 patients across 8 intervention categories were included in the analysis. SUCRA rankings indicated that electrical stimulation (SUCRA = 95.9%) was the most effective therapy for improving ICIQ-UI SF scores, followed by biofeedback electrical stimulation (SUCRA = 84.9%), radiofrequency (SUCRA = 77.5%), biofeedback (SUCRA = 57.8%), magnetic stimulation (SUCRA = 45.3%), pelvic floor muscle training (SUCRA = 38.4%), Er: YAG laser (SUCRA = 37.4%), and CO2 laser (SUCRA = 7.4%). In terms of reducing urine leakage, the treatments were ranked in descending order as follows: Er: YAG laser (SUCRA = 97.5%), biofeedback electrical stimulation (SUCRA = 83.4%), biofeedback (SUCRA = 67.0%), radiofrequency (SUCRA = 59.5%), electrical stimulation (SUCRA = 48.4%), pelvic floor muscle training (SUCRA = 43.0%), magnetic stimulation (SUCRA = 27.8%), and CO2 laser (SUCRA = 21.4%). Based on the clustered rankings of the two metrics, biofeedback electrical stimulation was identified as the most effective therapy for improving stress urinary incontinence.ConclusionBased on the combined analysis of two indicators, we found that biofeedback electrical stimulation may be the optimal therapy for the conservative management of stress urinary incontinence.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024569845.
format Article
id doaj-art-1c6c3d04bf3d4f5b82357747f7263ca6
institution OA Journals
issn 2296-858X
language English
publishDate 2024-12-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj-art-1c6c3d04bf3d4f5b82357747f7263ca62025-08-20T02:30:30ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-12-011110.3389/fmed.2024.15179621517962Conservative treatments for women with stress urinary incontinence: a systematic review and network meta-analysisMengzhen Li0Mengzhen Li1Kexin Qiu2Kexin Qiu3Haoran Guo4Haoran Guo5Mengsi Fan6Mengsi Fan7Li Yan8Li Yan9School of Public Health, Shandong Second Medical University, Weifang, ChinaDepartment of Gynecology, Shandong Provincial Qianfoshan Hospital, Shandong Second Medical University, Key Laboratory of Laparoscopic Technology, The First Affiliated Hospital of Shandong First Medical University, Jinan, ChinaSchool of Public Health, Shandong Second Medical University, Weifang, ChinaDepartment of Gynecology, Shandong Provincial Qianfoshan Hospital, Shandong Second Medical University, Key Laboratory of Laparoscopic Technology, The First Affiliated Hospital of Shandong First Medical University, Jinan, ChinaSchool of Public Health, Shandong Second Medical University, Weifang, ChinaDepartment of Gynecology, Shandong Provincial Qianfoshan Hospital, Shandong Second Medical University, Key Laboratory of Laparoscopic Technology, The First Affiliated Hospital of Shandong First Medical University, Jinan, ChinaSchool of Public Health, Shandong Second Medical University, Weifang, ChinaDepartment of Gynecology, Shandong Provincial Qianfoshan Hospital, Shandong Second Medical University, Key Laboratory of Laparoscopic Technology, The First Affiliated Hospital of Shandong First Medical University, Jinan, ChinaDepartment of Gynecology, Shandong Provincial Qianfoshan Hospital, Shandong Second Medical University, Key Laboratory of Laparoscopic Technology, The First Affiliated Hospital of Shandong First Medical University, Jinan, ChinaDepartment of Gynecology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, ChinaObjectiveThis study aimed to compare the effectiveness of various conservative treatment strategies for women with stress urinary incontinence.MethodsA comprehensive search of PubMed, Web of Science, Embase, and the Cochrane Library was conducted from their inception through March 2024, without restrictions on language or location. Randomized controlled trials (RCTs) comparing the efficacy of conservative treatments for stress urinary incontinence, using short-term pad test or the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) score as outcome measures, were included. We conducted a network meta-analysis using a random-effects model to compare the effectiveness of different conservative treatment strategies, employing prediction interval plots and league tables, and ranked them according to the surface under the cumulative ranking curve (SUCRA). The quality of the included studies was assessed following the Cochrane Handbook for Systematic Reviews of Interventions.ResultsA total of 31 RCTs involving 1,900 patients across 8 intervention categories were included in the analysis. SUCRA rankings indicated that electrical stimulation (SUCRA = 95.9%) was the most effective therapy for improving ICIQ-UI SF scores, followed by biofeedback electrical stimulation (SUCRA = 84.9%), radiofrequency (SUCRA = 77.5%), biofeedback (SUCRA = 57.8%), magnetic stimulation (SUCRA = 45.3%), pelvic floor muscle training (SUCRA = 38.4%), Er: YAG laser (SUCRA = 37.4%), and CO2 laser (SUCRA = 7.4%). In terms of reducing urine leakage, the treatments were ranked in descending order as follows: Er: YAG laser (SUCRA = 97.5%), biofeedback electrical stimulation (SUCRA = 83.4%), biofeedback (SUCRA = 67.0%), radiofrequency (SUCRA = 59.5%), electrical stimulation (SUCRA = 48.4%), pelvic floor muscle training (SUCRA = 43.0%), magnetic stimulation (SUCRA = 27.8%), and CO2 laser (SUCRA = 21.4%). Based on the clustered rankings of the two metrics, biofeedback electrical stimulation was identified as the most effective therapy for improving stress urinary incontinence.ConclusionBased on the combined analysis of two indicators, we found that biofeedback electrical stimulation may be the optimal therapy for the conservative management of stress urinary incontinence.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024569845.https://www.frontiersin.org/articles/10.3389/fmed.2024.1517962/fullstress urinary incontinenceconservative treatmentnetwork meta-analysisbiofeedback electrical stimulationlaser
spellingShingle Mengzhen Li
Mengzhen Li
Kexin Qiu
Kexin Qiu
Haoran Guo
Haoran Guo
Mengsi Fan
Mengsi Fan
Li Yan
Li Yan
Conservative treatments for women with stress urinary incontinence: a systematic review and network meta-analysis
Frontiers in Medicine
stress urinary incontinence
conservative treatment
network meta-analysis
biofeedback electrical stimulation
laser
title Conservative treatments for women with stress urinary incontinence: a systematic review and network meta-analysis
title_full Conservative treatments for women with stress urinary incontinence: a systematic review and network meta-analysis
title_fullStr Conservative treatments for women with stress urinary incontinence: a systematic review and network meta-analysis
title_full_unstemmed Conservative treatments for women with stress urinary incontinence: a systematic review and network meta-analysis
title_short Conservative treatments for women with stress urinary incontinence: a systematic review and network meta-analysis
title_sort conservative treatments for women with stress urinary incontinence a systematic review and network meta analysis
topic stress urinary incontinence
conservative treatment
network meta-analysis
biofeedback electrical stimulation
laser
url https://www.frontiersin.org/articles/10.3389/fmed.2024.1517962/full
work_keys_str_mv AT mengzhenli conservativetreatmentsforwomenwithstressurinaryincontinenceasystematicreviewandnetworkmetaanalysis
AT mengzhenli conservativetreatmentsforwomenwithstressurinaryincontinenceasystematicreviewandnetworkmetaanalysis
AT kexinqiu conservativetreatmentsforwomenwithstressurinaryincontinenceasystematicreviewandnetworkmetaanalysis
AT kexinqiu conservativetreatmentsforwomenwithstressurinaryincontinenceasystematicreviewandnetworkmetaanalysis
AT haoranguo conservativetreatmentsforwomenwithstressurinaryincontinenceasystematicreviewandnetworkmetaanalysis
AT haoranguo conservativetreatmentsforwomenwithstressurinaryincontinenceasystematicreviewandnetworkmetaanalysis
AT mengsifan conservativetreatmentsforwomenwithstressurinaryincontinenceasystematicreviewandnetworkmetaanalysis
AT mengsifan conservativetreatmentsforwomenwithstressurinaryincontinenceasystematicreviewandnetworkmetaanalysis
AT liyan conservativetreatmentsforwomenwithstressurinaryincontinenceasystematicreviewandnetworkmetaanalysis
AT liyan conservativetreatmentsforwomenwithstressurinaryincontinenceasystematicreviewandnetworkmetaanalysis