Supervised versus unsupervised pelvic floor muscle training in the treatment of women with urinary incontinence- a systematic review and meta-analysis

Kharaji, Ghazal; Shahali, Shabnam; Ebrahimi Takamjani, Ismaeil; Shanbehzadeh, Sanaz; Sarrafzadeh, Javad; Sanaei, Fateme

Supervised versus unsupervised pelvic floor muscle training in the treatment of women with urinary incontinence- a systematic review and meta-analysis

Kharaji G¹, Shahali S¹, Ebrahimi Takamjani I¹, Shanbehzadeh S¹, Sarrafzadeh J², Sanaei F³

Research Type

Clinical

Abstract Category

Female Lower Urinary Tract Symptoms (LUTS) / Voiding Dysfunction

Links
	Abstract 373
	Open Discussion ePosters Scientific Open Discussion Session 5
	Wednesday 27th September 2023
	12:40 - 12:45 (ePoster Station 3)
	Exhibit Hall
	Conservative Treatment Female Incontinence Pelvic Floor Physiotherapy
	1. Iran university of medical sciences, 2. Institute of Kidney Diseases, 3. Shahid Beheshti university of medical sciences
Presenter
G Ghazal Kharaji Iran university of medical sciences
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Abstract

Hypothesis / aims of study

This study synthesized the effects of supervised and unsupervised pelvic floor muscle training (PFMT) programs on outcomes relevant to women’s urinary incontinence (UI).

Study design, materials and methods

Five databases were searched from inception to December 2021 and the search was updated until June 28, 2022.
Randomized and non-randomized control trials (RCTs and NRCTs) comparing supervised and unsupervised PFMT in women with UI and reported urinary symptoms, quality of life (QoL), pelvic floor muscles (PFM) function/ strength, the severity of UI, and patient satisfaction outcomes, were included. Risk of bias assessment of eligible studies was performed by two authors through Cochrane risk of bias assessment tools. The meta-analysis was conducted using a random effects model with the mean difference or standardized mean difference

Results

Six RCTs and one NRCT study were included. All RCTs were assessed as "high risk of bias" and the NRCT study was rated as "serious risk of bias" for almost all domains. The results showed that supervised PFMT is better than unsupervised for QoL and PFMs function of women with UI. There was no difference between supervised and unsupervised PFMT for urinary symptoms and improvement of the severity of UI.

Interpretation of results

Results of patient satisfaction were inconclusive due to the sparse literature. However, supervised, and unsupervised PFMT with thorough education and regular reassessment showed better results than unsupervised PFMT without educating patients about correct PFMs contractions.

Concluding message

Supervised and unsupervised PFMT programs, can both be effective in treating women's UI if training sessions and regular reassessments are provided.

Figure 1

risk of bias summary about each risk of bias domain for each included Randomised Controlled trial (RCT) separately

Figure 2

Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow diagram mapping the review

Disclosures

Funding none Clinical Trial No Subjects None

International Continence Society