Conservative interventions for urinary incontinence in women: an overview of Cochrane systematic reviews

McClurg, Doreen; Campbell, Pauline; Pollock, Alex; Hagen, Suzanne; Elders, Andrew; Hill, Dorian; Hazelton, Christine

doi:10.1016/j.physio.2017.11.185

Cited by 3 publications

(4 citation statements)

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“…Women with GSM, especially those with UI, require multidisciplinary care; therefore, a wide range of conservative management (lifestyle change), pharmacological and surgical interventions are used for the treatment of urogenital symptoms [22, 23]. If the first-line therapies (conservative management) prove ineffective in treating UI, a number of pharmacological options are available, including HRT, anticholinergic and adrenergic medications, and serotonin-noradrenaline reuptake inhibitors.…”

Section: Discussionmentioning

confidence: 99%

“…If the first-line therapies (conservative management) prove ineffective in treating UI, a number of pharmacological options are available, including HRT, anticholinergic and adrenergic medications, and serotonin-noradrenaline reuptake inhibitors. The results of previous studies have shown poor adherence to medication therapy due to common side effects, moderate effectiveness, and delayed therapeutic effects [23-25].…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Panax ginseng on Genitourinary Syndrome in Postmenopausal Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

et al. 2021

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Background: Menopause and estrogen deprivation cause a rise in the number of urogenital tract complaints. Objective: This study was conducted to assess the effectiveness of ginseng on genitourinary syndrome. Methods: This randomized trial was conducted on 60 postmenopausal women with genitourinary syndrome. The participants were randomly allocated to ginseng and placebo groups twice daily for 4 weeks. Vaginal maturation index and vaginal pH were evaluated before and 4 weeks after intervention as the primary outcomes. Also, the atrophic vaginitis and incontinence questionnaires were completed before and after intervention as the secondary outcomes. The safety of intervention was assessed by the side effects checklist. Results: No significant differences were observed between the 2 groups in objective symptoms after the intervention, but the difference was statistically significant (p < 0.001) in terms of subjective symptoms of atrophic vaginitis. One case of insomnia and palpitation and 2 cases of hot flashes were reported in the intervention group, and 1 case of gastric discomfort and change in urine appearance was reported in the placebo group. Conclusion: Ginseng only improved the patient-assessed symptoms and had no significant effect on the clinician-assessed outcomes. Further studies are required to determine the precise pharmacological mechanisms of ginseng on genitourinary syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Effect of Panax ginseng on Genitourinary Syndrome in Postmenopausal Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

et al. 2021

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“…Medline, Embase, PsycInfo, CINAHL and the Cochrane Library were used as the sources of systematic reviews for inclusion in this review. The source used to assist in defining the search strategies was the Cochrane Incontinence Group list for hand searchers [17] (see Supplementary Data, Appendix 1). There were no date restrictions set on the searches and records were searched from inception until 29 th June 2018.…”

Section: Search Methodsmentioning

confidence: 99%

Non-pharmacological, non-surgical interventions for urinary incontinence in older persons: A systematic review of systematic reviews. The SENATOR project ONTOP series

et al. 2020

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Background: Urinary incontinence is especially common in older age. Nonpharmacological therapies are particularly desirable in this group. Objective: To define optimal evidence-based non-pharmacological, non-surgical therapies for urinary incontinence in older persons. Methods: A Delphi process determined critical outcome measures of interest. Studies of any non-pharmacological intervention reporting critical outcomes were identified through database searches for relevant systematic reviews in Medline, Embase, CINAHL, PsycInfo and Cochrane by June 2018. Primary trials with a population mean age ≥65years were identified with subsequent data extraction and risk of bias assessment. Qualitative analysis and meta-analysis, when possible, were undertaken followed by grading of the evidence using GradePro software. Finally, bullet-point recommendations were formulated for the indications and contraindications for non-pharmacological interventions for urinary incontinence in older persons. Results: Frequency of incontinence was identified as a critically important outcome. In total, 33 systematic reviews were identified with 27 primary trials meeting inclusion criteria. Evaluated therapies included exercise therapy, habit retraining, behavioural therapy, electrical stimulation, transcutaneous tibial nerve stimulation, magnetic stimulation, caffeine reduction and acupuncture. From meta-analysis, group exercise therapy and behavioural therapy in women were beneficial in reducing episodes of incontinence (mean reduction of 1.07 (95%CI 0.69-1.45) and 0.74 (95%CI 0.42-1.06) episodes per day respectively, evidence grade 'moderate'). Evidence for other interventions was limited and of insufficient quality. 4 Conclusions: There is sufficient evidence to warrant recommendation of group exercise therapy for stress incontinence and behavioural therapy for urgency, stress or mixed urinary incontinence in older women. Evidence was insufficient to recommend any other non-drug therapy.

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“…The pooled analysis of studies (n=503) of low methodological and very low-grade quality revealed no superior benefits of Paula exercise compared to PFMT for the treatment of SUI in women. Paula exercise works on the principle that all sphincters in the body work in a synchronized manner [34,35]; therefore, exercising the circular muscles of the mouth, eyes or nose may result in PFMs cocontractions [12,15]. However, a scientific premise for contracting the circular muscles of the face to facilitate PFMs co-contraction is lacking.…”

Section: Amount Of Urine Leak In Gramsmentioning

confidence: 99%

Efficacy of Mind-Body Therapies for the Treatment of Urinary Incontinence in Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Kannan¹,

SL²,

Boghra³

2021

austinjwomenshealth

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Introduction: The efficacy of mind-body therapies to manage urinary incontinence in women is outdated and inconclusive. This review aims to determine the efficacy of mind - body therapies for Stress Urinary Incontinence (SUI) in women. Methods: The databases AMED, CINAHL, EMBASE, Medline, Physiotherapy Evidence Database (PEDro), PubMed, Scopus, and Web of Science, were searched from database inception until May 2020. Randomized controlled trials comparing mind-body therapies to control were included. The methodological quality and the quality of the evidence were evaluated using the Physiotherapy Evidence Database (PEDro) scale and the Grading of Recommendations, Assessment, Development, and Evaluation tool, respectively. The risk of bias was assessed using the Cochrane risk of bias tool. Results: Six studies were included in the review. Pooled analysis of data from two studies of low to high methodological quality, low-grade evidence revealed a statistically significant decrease in the number of SUI episodes in the yoga group than in the control group (MD 0.83 [95% CI-1.64 to 0.02]; p=0.04). Pooled analysis of three methodologically low-quality, very low-grade studies revealed no significant difference between groups receiving Paula exercise and pelvic floor muscle training on grams of urine lost in the 1h pad test (MD 0.15 [95% CI-1.15 to 1.46] p=0.82). Conclusions: This review found hatha yoga poses intended to address the pelvic floor as beneficial for managing SUI in women. Yoga is a low-risk intervention and therefore it may be considered for clinical use. The effect of Paula exercise on SUI remains inconclusive.

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Conservative interventions for urinary incontinence in women: an overview of Cochrane systematic reviews

Cited by 3 publications

References 0 publications

The Effect of <b><i>Panax ginseng</i></b> on Genitourinary Syndrome in Postmenopausal Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

The Effect of <b><i>Panax ginseng</i></b> on Genitourinary Syndrome in Postmenopausal Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Non-pharmacological, non-surgical interventions for urinary incontinence in older persons: A systematic review of systematic reviews. The SENATOR project ONTOP series

Efficacy of Mind-Body Therapies for the Treatment of Urinary Incontinence in Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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