Department of Surgery, Division of Urology, Persahabatan General Hospital, Jakarta, Indonesia.
Department of Surgery, Division of Urology, Persahabatan General Hospital - Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Neurourol Urodyn. 2022 Aug;41(6):1258-1269. doi: 10.1002/nau.24984. Epub 2022 Jun 10.
This meta-analysis aims to compare biofeedback-assisted pelvic muscle floor training (PFMT) and pelvic electrical stimulation (ES) as an intervention group, with PFMT or bladder training (BT) as the control group, in women with an overactive bladder (OAB).
PubMed, Cochrane, CINAHL, EMBASE, and Scopus were systematically searched for randomized controlled trials (RCTs) published up to November 2021. The RCTs were screened for our eligibility criteria and quality was evaluated using the Cochrane Risk Index of Bias tools. The outcomes were changes in quality of life (QoL), episodes of incontinence, and the number of participants cured/improved.
Eight studies involving 562 patients (comprising 204 patients with biofeedback-assisted PFMT, 108 patients with pelvic ES, and 250 patients who received PFMT alone or BT and lifestyle recommendations only, as the control group) were included. The ES group showed significant differences in terms of changes to QoL (mean difference [MD]: 7.41, 95% confidence interval [CI]: 7.90-12.92, p = 0.008), episodes of incontinence (MD: -1.33, 95% CI: -2.50 to -0.17, p = 0.02), and the number of participants cured or improved (risk ratio [RR]: 1.46, 95% CI: 1.14-1.87, p = 0.003), while the biofeedback group resulted in nonsignificant changes in QoL (MD: 0.13, 95% CI: 7.87-8.12, p = 0.98), episodes of incontinence (MD: 0.01, 95% CI: -0.89 to 0.90, p = 0.99), and the number of participants cured or improved (RR: 1.15, 95% CI: 0.99-1.33, p = 0.08), both compared to the control group respectively.
This meta-analysis shows that low-frequency pelvic ES appears to be sufficient and effective as an additional intervention for women with OAB in clinical practice according to improvements in the subjects' QoL and reduction of symptoms. Meanwhile, biofeedback-assisted PFMT does not appear to be a significant adjuvant for conservative OAB therapy.
本荟萃分析旨在比较生物反馈辅助盆底肌肉锻炼（PFMT）和盆底电刺激（ES）作为干预组，与 PFMT 或膀胱训练（BT）作为对照组，治疗膀胱过度活动症（OAB）女性。
系统检索了 PubMed、Cochrane、CINAHL、EMBASE 和 Scopus 数据库，以获取截至 2021 年 11 月发表的随机对照试验（RCT）。根据我们的纳入标准筛选 RCT，并使用 Cochrane 风险偏倚指数工具评估质量。结局指标为生活质量（QoL）变化、失禁发作次数和治愈/改善的参与者人数。
纳入了 8 项研究，共 562 名患者（包括 204 名接受生物反馈辅助 PFMT 的患者、108 名接受盆底 ES 的患者和 250 名仅接受 PFMT 或 BT 以及生活方式建议作为对照组的患者）。ES 组在 QoL 变化（平均差异 [MD]：7.41，95%置信区间 [CI]：7.90-12.92，p=0.008）、失禁发作次数（MD：-1.33，95% CI：-2.50 至 -0.17，p=0.02）和治愈或改善的参与者人数（风险比 [RR]：1.46，95% CI：1.14-1.87，p=0.003）方面表现出显著差异，而生物反馈组在 QoL 变化（MD：0.13，95% CI：7.87-8.12，p=0.98）、失禁发作次数（MD：0.01，95% CI：-0.89 至 0.90，p=0.99）和治愈或改善的参与者人数（RR：1.15，95% CI：0.99-1.33，p=0.08）方面无显著差异，与对照组相比分别。
根据本荟萃分析，低频盆底 ES 似乎是一种足够且有效的附加干预措施，可改善女性 OAB 患者的生活质量并减轻症状。同时，生物反馈辅助 PFMT 似乎不是保守性 OAB 治疗的重要辅助手段。
