Effect of conservative treatment of pelvic floor dysfunctions in women: An umbrella review

Abstract

Due to their high worldwide prevalence, pelvic floor dysfunctions (PFD's) are a public health problem. There is high heterogeneity in the types and effectiveness of conservative treatment. The objective was to analyze the scientific evidence on conservative treatment of PFDs in women. Umbrella review, covering MEDLINE (1950-2019), Scopus (1960-2019), Web of Science (1980-2019), and Cochrane Library (2000-2019). Inclusion criterion: review on conservative treatments about pelvic floor disorders in the adult women, in Spanish or English; exclusion criterion: studies about other urological, gynecological, and coloproctological pathologies, among others. Thirty-two reviews (2000-2019) and 12 meta-analyses were included. 53.1% showed an improvement on urinary incontinence. Pelvic floor muscle training worked on 70.6% of them, followed by electrical stimulation and estrogen (11.7%), and weight loss (5.9%). 6.3% of reviews and meta-analyses fulfilled all items in PRISMA, and 93.7% of them fulfilled more than 60% of the checklist. 60% de los ítems. PFMT and weight loss are the most effective treatments for UI, but there is no evidence for other PFDs. The methodological quality of conservative treatments must be improved for a more effective treatment of PFDs in women. Pelvic floor muscle training and weight loss are the most effective treatments for urinary incontinence. Only 6.3% of the reviews fulfilled all PRISMA ítems.