Ghaderi Fariba, Kharaji Ghazal, Hajebrahimi Sakineh, Pashazadeh Fariba, Berghmans Bary, Pourmehr Hanieh Salehi
Department of Physiotherapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Physiotherapy, Faculty of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Urol Res Pract. 2023 Sep;49(5):293-306. doi: 10.5152/tud.2023.23018.
Physiotherapy is the most commonly used treatment for stress urinary incontinence including pelvic floor muscle training, biofeedback, and electrical stimulation. This systematic review evaluated the effects of physiotherapy in patients with stress urinary incontinence compared with no treatment, placebo, sham, surgery, or other inactive control treatments. MEDLINE (via PubMed), The Cochrane Library (CENTRAL), Embase, Scopus, Web of Science, PEDro, and Trip Database were explored using applicable vocabularies for all English and Persian language investigations released from inception to January 2021. On one side, trials including physiotherapy of pelvic floor muscle training, biofeedback, and electrical stimulation and on the other, either no treatment, placebo, sham, surgery, or other inactive control treatments were included. Studies were assessed for appropriateness and methodological excellence. Two authors extracted data. Disagreements were resolved by a third opinion. Data were processed as described in the Joanna Briggs Institute Handbook. Twenty-nine trials with 2601 participants were found, but only 16 were included because of data heterogeneity. The results showed that physiotherapy interventions are better than no treatment in terms of urine leakage, but no difference was found for urinary incontinence severity. Also, physiotherapy showed favorable results over comparison groups for International Consultation on Incontinence Questionnaire, pad test, pelvic floor muscle function, and improvement outcomes. This systematic review supports the widespread use of pelvic physiotherapy as the first-line treatment for adult patients with stress urinary incontinence.
物理治疗是压力性尿失禁最常用的治疗方法，包括盆底肌肉训练、生物反馈和电刺激。本系统评价评估了物理治疗与不治疗、安慰剂、假治疗、手术或其他非活性对照治疗相比，对压力性尿失禁患者的疗效。通过适用词汇检索了MEDLINE（通过PubMed）、Cochrane图书馆（CENTRAL）、Embase、Scopus、Web of Science、PEDro和Trip数据库，以查找从创刊到2021年1月发布的所有英文和波斯文语言研究。一方面，纳入包括盆底肌肉训练、生物反馈和电刺激的物理治疗试验，另一方面，纳入不治疗、安慰剂、假治疗、手术或其他非活性对照治疗试验。对研究的适宜性和方法学质量进行评估。两名作者提取数据。分歧通过第三方意见解决。数据按照乔安娜·布里格斯研究所手册中的描述进行处理。共检索到29项试验，2601名参与者，但由于数据异质性，仅纳入16项。结果表明，在漏尿方面，物理治疗干预优于不治疗，但在尿失禁严重程度方面未发现差异。此外，在国际尿失禁咨询问卷、尿垫试验、盆底肌肉功能和改善结果方面，物理治疗与对照组相比显示出良好的效果。本系统评价支持广泛使用盆腔物理治疗作为成年压力性尿失禁患者的一线治疗方法。
