A Systematic Review With Meta-Analysis on the Role of Pelvic Floor Muscle Exercises on the Severity of Symptoms and Quality of Life in Women With Urinary Incontinence.

Abstract

Background: Involuntary urine loss, also known as urinary incontinence (UI), commonly affects women as a result of pelvic floor weakness or bladder malfunction. Despite conflicting and inconclusive data, pelvic floor muscle training (PFMT) is frequently used to treat individuals with stress urinary incontinence (SUI). This study was designed to investigate the effectiveness of PFMT in females with SUI.

Methods: PubMed, the cochrane library, embase, science direct, web of science, scopus, and google scholar databases were searched until 31st October 2023. Included peer reviewed randomized controlled trials (RCTs) published in English language that assessed effect of PFMT in stress-related UI. The I² test and a funnel plot were used to analyze heterogeneity and publication bias. Risk of bias was assessed using the Joanna Briggs Institute (JBI) checklist. Random-effects meta-analysis was performed.

Results: 14 publications, primarily RCTs, were selected from 8440 citations for the final qualitative analysis. Articles were published between 2010 and 2023, with 2192 total participants ranging from 30 to 600 and aged 18-80 were included. PFMT shows 14% absolute reduction in UI (risk difference (RD) = 0.14; 95% confidence interval (CI): 0.04-0.25; p = 0.01) and significantly improved quality of life (QoL) (RD = 0.17; 95% CI: 0.06-0.29; p < 0.01). Substantial heterogeneity was explored through subgroup and sensitivity analyses.

Conclusions: This meta-analysis showed that PFMT reduces UI and improves the QoL in women. The PROSPERO registration: The study was registered at Clinicaltrials.gov (https://www.crd.york.ac.uk/PROSPERO/view/CRD420261339337), registration number: CRD420261339337.