Faculty of Medicine, University of Montréal, Research Center of the Institut Universitaire de Gériatrie, Montreal, QC, Canada.
Faculty of Medicine, University of Montréal, Research Center of the Institut Universitaire de Gériatrie, Montreal, QC, Canada; Canadian Research Chair in Urogynecological Health and Aging, Montreal, QC, Canada.
Braz J Phys Ther. 2019 Mar-Apr;23(2):93-107. doi: 10.1016/j.bjpt.2019.01.002. Epub 2019 Jan 22.
Pelvic floor muscle training is the most commonly used physical therapy treatment for women with urinary incontinence.
To assess the effects of Pelvic floor muscle training for women with urinary incontinence in comparison to a control treatment and to summarize relevant economic findings.
Cochrane Incontinence Group Specialized Register (February 12, 2018).
Randomized or quasi-randomized trials in women with stress, urgency or mixed urinary incontinence (symptoms, signs, or urodynamic).
Trials were independently assessed by at least two reviewers authors and subgrouped by urinary incontinence type. Quality of evidence was assessed by adopting the Grading of Recommendations, Assessment, Development and Evaluation approach.
The review included thirty-one trials involving 1817 women from 14 countries. Overall, trials were small to moderate size, and many were at moderate risk of bias. There was considerable variation in the intervention's content and duration. Based on data available, we can be confident that Pelvic floor muscle training can cure or improve symptoms of stress and all other types of urinary incontinence. It may reduce the number of leakage episodes and the quantity of leakage, while improving reported symptoms and quality of life. Women were more satisfied with Pelvic floor muscle training, while those in control groups were more likely to seek further treatment. Long-term effectiveness and cost-effectiveness of Pelvic floor muscle training needs to be further researched.
The addition of ten new trials did not change the essential findings of the earlier review, suggesting that Pelvic floor muscle training could be included in first-line conservative management of women with urinary incontinence.
盆底肌训练是治疗女性尿失禁最常用的物理治疗方法。
评估盆底肌训练对女性尿失禁的效果，与对照治疗相比，并总结相关的经济发现。
Cochrane 尿失禁组专业注册（2018 年 2 月 12 日）。
随机或半随机试验，纳入压力性、急迫性或混合性尿失禁（症状、体征或尿动力学）的女性。
试验由至少两名独立评估的作者进行，按尿失禁类型进行亚组分析。证据质量采用推荐、评估、发展和评估方法进行评估。
综述包括 31 项试验，涉及 14 个国家的 1817 名女性。总体而言，试验规模较小，许多试验存在中度偏倚风险。干预措施的内容和持续时间存在很大差异。根据现有数据，我们可以有信心地认为，盆底肌训练可以治愈或改善压力性和所有其他类型的尿失禁症状。它可以减少漏尿次数和漏尿量，同时改善报告的症状和生活质量。女性对盆底肌训练更满意，而对照组的女性更可能寻求进一步的治疗。盆底肌训练的长期效果和成本效益需要进一步研究。
新增的 10 项试验并未改变早期综述的基本发现，表明盆底肌训练可以被纳入女性尿失禁的一线保守治疗。
