Adrenergic agonists1111. Alhasso AA, Glazener CM, Pickard R, N'Dow JM. Adrenergic drugs for urinary incontinence in adults. Cochrane Database Syst Rev. 2005;(3):CD001842. doi: 10.1002/14651858.CD001842.pub2. https://doi.org/10.1002/14651858.CD00184...
|
Placebo |
Stress |
Adrenergic agonists seem to be better for: |
Not assessed |
•reducing the number of pad changes |
•reducing incontinence episodes |
• improving symptoms |
Estrogen (systemic or local)1212. Cody JD, Jacobs ML, Richardson K, Moehrer B, Hextall A. Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database Syst Rev. 2012 Oct 17;10:CD001405. doi: 10.1002/14651858.CD001405.pub3. https://doi.org/10.1002/14651858.CD00140...
|
Placebo |
Not specified |
Favors placebo: |
Low |
•Improvement of urinary incontinence (oral systemic estrogen) |
Low |
No difference between groups: |
Moderate |
•Urinary incontinence episodes over 24 hours |
Low |
•Women with urge incontinence (systemic estrogens) |
Favors estrogen: |
Moderate |
•Women with urge incontinence (local estrogen) |
Very low |
•Improvement of urinary incontinence (local estrogen) |
•Improvement of urinary incontinence (local systemic estrogen) |
SNRI 1313. Mariappan P, Ballantyne Z, N'Dow JM, Alhasso AA. Serotonin and noradrenaline reuptake inhibitors (SNRI) for stress urinary incontinence in adults. Cochrane Database Syst Rev. 2005;(3):CD004742. doi: 10.1002/14651858.CD004742.pub2. https://doi.org/10.1002/14651858.CD00474...
|
Placebo and PFMT |
Stress |
Favors SNRI: |
Not assessed |
•Higher proportion of participants with symptom improvement |
Favors control group: |
•Lower rate of adverse events |
No difference between groups: |
•Rate of cure |
Adding biofeedback and feedback to other therapies1414. Herderschee R, Hay-Smith EJC, Herbison GP, Roovers JP, Heineman MJ. Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev. 2011;(7):CD009252. doi: 10.1002/14651858.CD009252. https://doi.org/10.1002/14651858.CD00925...
|
Other therapies without biofeedback |
Urge and mixed |
Favors addition of biofeedback: |
Not assessed |
•Women’s perception of change in incontinence |
•Women’s satisfaction |
Bladder training1515. Wallace SA, Roe B, Williams K, Palmer M. Bladder training for urinary incontinence in adults. Cochrane Database Syst Rev. 2004;(1):CD001308. doi: 10.1002/14651858.CD001308.pub2. https://doi.org/10.1002/14651858.CD00130...
|
Pharmacological therapy, PFMT, biofeedback |
Not specified |
Favors bladder training: |
Not assessed |
•Better patient perception of cure |
•Improvement of quality of life |
Habit retraining1616. Ostaszkiewicz J, Chestney T, Roe B. Habit retraining for the management of urinary incontinence in adults. Cochrane Database Syst Rev. 2004;(2):CD002801. doi: 10.1002/14651858.CD002801.pub2. https://doi.org/10.1002/14651858.CD00280...
|
No intervention |
Not specified |
No evidence available |
Not assessed |
Lifestyle interventions1717. Imamura M, Williams K, Wells M, McGrother C. Lifestyle interventions for the treatment of urinary incontinence in adults. Cochrane Database Syst Rev. 20152;(12):CD003505. doi: 10.1002/14651858.CD003505.pub5. https://doi.org/10.1002/14651858.CD00350...
|
Any other intervention |
Not specified |
Favors weight loss program: |
Low |
•Patient’s subjective impression of improvement |
No difference between groups: |
Low |
•Cure rates |
Very low |
•Frequency of incontinence episodes per week |
Prompted voiding1818. Eustice S, Roe B, Paterson J. Prompted voiding for the management of urinary incontinence in adults. Cochrane Database Syst Rev. 2000;(2):CD002113. doi: 10.1002/14651858.CD002113. https://doi.org/10.1002/14651858.CD00211...
|
No intervention or other behavioral intervention |
Not specified |
Favors prompted voiding: |
Not assessed |
Lower proportion of hourly checks that were wet |
Fewer incontinent episodes |
Timed voiding1919. Ostaszkiewicz J, Johnston L, Roe B. Timed voiding for the management of urinary incontinence in adults. Cochrane Database Syst Rev. 2004;(1):CD002802. doi: 10.1002/14651858.CD002802.pub2. https://doi.org/10.1002/14651858.CD00280...
|
Pharmacological and behavioral therapies |
Not specified |
No evidence available |
Not assessed |
Absorbent products2020. Fader M, Cottenden AM, Getliffe K. Absorbent products for moderate-heavy urinary and/or faecal incontinence in women and men. Cochrane Database Syst Rev. 2008;(4):CD007408. doi: 10.1002/14651858.CD007408. https://doi.org/10.1002/14651858.CD00740...
|
Other absorbent product |
Not specified |
No evidence available |
Not assessed |
Acupuncture2121. Wang Y, Zhishun L, Peng W, Zhao J, Liu B. Acupuncture for stress urinary incontinence in adults. Cochrane Database Syst Rev. 2013;(7):CD009408. doi: 10.1002/14651858.CD009408.pub2. https://doi.org/10.1002/14651858.CD00940...
|
Pharmacological intervention (midodrine) |
Stress |
Favors acupuncture: |
Not assessed |
•Improvement of symptoms (subjective assessment) |
No difference between groups: |
•Cure rate |
Mechanical devices2222. Lipp A, Shaw C, Glavind K. Mechanical devices for urinary incontinence in women. Cochrane Database Syst Rev. 2014;(12):CD001756. doi: 10.1002/14651858.CD001756.pub6. https://doi.org/10.1002/14651858.CD00175...
|
No intervention, sham or other interventions |
Not specified |
No evidence available |
Not assessed |
Transurethral radiofrequency collagen denaturation2323. Kang D, Han J, Neuberger MM, et al. Transurethral radiofrequency collagen denaturation for the treatment of women with urinary incontinence. Cochrane Database Syst Rev. 2015;(3):CD010217. doi: 10.1002/14651858.CD010217.pub2. https://doi.org/10.1002/14651858.CD01021...
|
Sham |
Not specified |
No difference between groups: |
Low |
•Quality of life |
•Adverse events |
•Urinary tract infection |
Any intervention2424. Thomas LH, Cross S, Barrett J, et al. Treatment of urinary incontinence after stroke in adults. Cochrane Database Syst Rev. 2008;(1):CD004462. doi: 10.1002/14651858.CD004462.pub3. https://doi.org/10.1002/14651858.CD00446...
|
Different intervention, no intervention or placebo |
Urinary incontinence after stroke |
Favors meclofenoxate (compared with placebo): |
Not assessed |
•Reduction of urinary symptom perception |
Favors acupuncture (compared with usual care/no intervention): |
•Reduction in number of participants with incontinence |
Urethral injection therapy2525. Kirchin V, Page T, Keegan PE, et al. Urethral injection therapy for urinary incontinence in women. Cochrane Database Syst Rev. 2017;7:CD003881. doi: 10.1002/14651858.CD003881.pub4. https://doi.org/10.1002/14651858.CD00388...
|
Conservative or surgical management |
Not specified |
Favors injection: |
Not assessed |
•Improvement of incontinence |
•Quality of life (compared with conservative treatment) |
Favors surgical treatment: |
•Symptom improvement |
Weighted vaginal cones2626. Herbison GP, Dean N. Weighted vaginal cones for urinary incontinence. Cochrane Database Syst Rev. 2013;(7):CD002114. doi: 10.1002/14651858.CD002114.pub2. https://doi.org/10.1002/14651858.CD00211...
|
No treatment, PFMT, electrostimulation |
Stress |
Favors vaginal cones: |
Not assessed |
•Incontinence cure (compared with no treatment) |
No difference between groups: |
•Subjective cure assessment (compared with pelvic exercises or electrostimulation) |
PFMT plus active treatment2727. Dumoulin C, Hay-Smith EJ, Mac Habée-Séguin G. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2014;(5):CD005654. doi: 10.1002/14651858.CD005654.pub3. https://doi.org/10.1002/14651858.CD00565...
|
Active treatment alone |
Stress, urge and mixed |
•PFMT plus electrical stimulation versus electrical stimulation alone: no difference between groups regarding cure or improvement of symptoms |
Low |
•PFMT plus heat/steam-generating sheet versus heat/steam sheet alone: benefit of PFMT regarding cure and symptom improvement |
Moderate |
•PFMT plus vaginal cones versus vaginal cones alone: no difference between groups |
Very low |
PFMT |
No treatment, placebo or sham2828. Hay-Smith EJ, Herderschee R, Dumoulin C, Herbison GP. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev. 2011;(12):CD009508. doi: 10.1002/14651858.CD009508. https://doi.org/10.1002/14651858.CD00950...
|
Stress, urge and mixed |
Favors PFMT: •Cure at end of follow-up |
High |
•Symptom improvement |
Moderate |
Different approaches for PFMT2929. Boyle R, Hay-Smith EJ, Cody JD, Mørkved S. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2012;10:CD007471. doi: 10.1002/14651858.CD007471.pub2. https://doi.org/10.1002/14651858.CD00747...
|
Stress, urge and mixed |
•Perception of improvement: better with supervision twice a week than once a week No difference between groups: |
Not assessed |
•Perception of improvement: no difference between group supervision and individual supervision, or between direct and indirect methods of PFMT |
PFMT in antenatal and postnatal period3030. Ayeleke RO, Hay-Smith EJ, Omar MI. Pelvic floor muscle training added to another active treatment versus the same active treatment alone for urinary incontinence in women. Cochrane Database Syst Rev. 2015;(11):CD010551. doi: 10.1002/14651858.CD010551.pub3. https://doi.org/10.1002/14651858.CD01055...
|
No treatment, different approaches for PFMT in antenatal and postnatal period3030. Ayeleke RO, Hay-Smith EJ, Omar MI. Pelvic floor muscle training added to another active treatment versus the same active treatment alone for urinary incontinence in women. Cochrane Database Syst Rev. 2015;(11):CD010551. doi: 10.1002/14651858.CD010551.pub3. https://doi.org/10.1002/14651858.CD01055...
|
Not specified |
Favors intensive antenatal PFMT: |
Not assessed |
•Incidence of incontinence over first six months after delivery (prevention) |
Favors intensive postnatal PFMT: |
•Rate of incontinence 12 months after delivery (treatment) |