The literature regarding the effectiveness of PFMT in OAB remains heterogeneous and inconclusive.

(Abstracted from Int Urogynecol J 2018; doi: 10.1007/s00192-018-3602-x) In the adult population, the prevalence of symptoms in an overactive bladder (OAB) is approximately 17%. In women, it can reach 50%.

Introduction Low-level lasers have been suggested as a complement to lymphedema treatment. However, this therapy’s mechanism of action and its effects are poorly understood up to the present. Objective To conduct a systematic literature review to analyze the effects of low-level laser in the treatment of upper-limb lymphedema in women submitted to breast cancer surgery. Material and methods Randomized clinical trials were included, in Portuguese, English and Spanish, from January 1990 to July 2013. The article search was carried out in the Pubmed, Lilacs and PEDro electronic databases, with the following descriptors:Terapia a Laser de Baixa Intensidade, Linfedema, Câncer de Mama, Low-level laser therapy, Lymphedema, Breast Neoplasms and also through a manual search. Results and discussion Low-level lasers have been used for treating several acute and chronic conditions. However, its application for managing post breast cancer surgery is still recent, often based on empirical evidence. Treating upper-limb lymphedema with low-level laser presented positive results, with reduction in the circumference or volume of the affected limb. Conclusion More studies of high methodological quality are needed in order to better understand the mechanism of action of low-level laser on the lymphatic system and its effects on lymphedema treatement.

Introduction The aim of this systematic review will be to investigate and update whether bladder training can promote improvement of symptoms of overactive bladder syndrome with or without urgency urinary incontinence in adults.   Methods We will perform a systematic review according to the Cochrane methodology of randomized controlled trials. An overall search strategy will be developed and adapted for each database. A bibliographic search will be conducted in eight databases - PubMed, PEDro, SciELO, LILACS, Cochrane Library, Web of Science, EMBASE, CINAHL, by manual searching. The MeSH terms will be “Bladder Training”, “Bladder Drill”, “Bladder Re-education”, “Bladder Retraining”, “Bladder Discipline”, “Overactive Bladder”, “Bladder, Overactive”, “Overactive Urinary Bladder”, “Urinary Bladder”, “Overactive, Urinary Bladder”, “Bladder, Urinary”, “Urinary Bladder Disease”, “Bladder Disease”, “Bladder Detrusor Muscle” and “Detrusor Muscle, Bladder”. Meta-analysis, if plausible, will be performed by the software Review Manager 5.4. Primary outcomes : symptoms of overactive bladder syndrome (urinary urgency with daytime voiding frequency, nocturia with or without urgency urinary incontinence), and cure/improvement assessed by instruments. Secondary outcomes : quality of life, functional assessment, validated scale/questionnaire and adverse events. Quality assessment will be performed by Cochrane instrument and quality of evidence will be assessed by GRADE.   Discussion This study is a review of randomized controlled studies to analyze the efficacy of bladder training in improving the symptoms of adults with overactive bladder syndrome. The study design of randomized controlled trials for a higher level of scientific evidence was chosen. The aim is to obtain results that allow further studies and evidence that this intervention generates beneficial effects in the sample studied.

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Background The International Continence Society recommends that first-line treatment of overactive bladder syndrome symptoms and urgency urinary incontinence is performed by conservative interventions. Bladder training is considered one of the types of behavioral intervention, which is characterized by health education associated with scheduled voiding regimen with gradually adjusted voiding intervals. The aim of this study will be to investigate and update whether bladder training can promote improvement of symptoms of individuals with overactive bladder with or without urgency urinary incontinence. Methods A bibliographic search will be conducted in eight databases, no data or language restrictions: PubMed, PEDro, SciELO, LILACS, Cochrane Library, Web of Science, EMBASE, CINAHL, by handing searching. A combination of search terms including ‘bladder training’, 'overactive bladder', ‘urinary incontinence’ and 'urinary urgency incontinence' with common Boolean operators will be used. Specific search terms will be combined with either MeSH and search descriptors terms and appropriate permutations for each database. Search findings will be imported into the Reference Management Software (Mendeley 2.67.0) then uploaded where two reviewers will screen the titles, abstracts and retrieved full text. In case of conflicts and moderate consensus discussions, a third reviewer will be available. The Mixed Methods Appraisal Tool (MMAT) will be used to appraise the quality of mixed studies (quantitative and qualitative) by limiting them to criteria. The primary outcome will be the improvement of OAB symptoms and the secondary outcomes will be the quality of life, functional assessment and adverse events, which can be assessed by questionnaires and measurement instruments. Meta-analysis, if plausible, will be performed by the software Review Manager 5.4. Cochrane RoB 2 assesses the risk of bias for randomized trials and quality of evidence will be assessed by GRADE. Discussion This study is a review of randomized controlled studies to analyze the efficacy of bladder training improving overactive bladder syndrome symptoms. The study design of randomized controlled trials for a higher level of scientific evidence was chosen. The aim is to obtain results that allow further studies and evidence that this intervention generates beneficial effects in the sample studied. Systematic review registration: PROSPERO CRD42022301522.

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