Efficacy of electrical stimulation in comparison to active training of pelvic floor muscles on stress urinary incontinence symptoms in women: a systematic review with meta-analysis

Abstract

Objective Comparing the efficacy of electrical stimulation (ES) and pelvic floor muscles training (PFMT) on urinary incontinence (UI) symptoms, quality of life and sexual function on women with stress UI. Also, to analyze the influence of supervised and non-supervised PFMT. Methods Systematic review of randomized trials involving adult women with stress UI. Studies’ review was performed by two independent researchers on PubMed, EMBASE, PEDro, Cochrane Library, LILACS. The PEDro scale was used to evaluate the quality of included studies. The certainty of evidence was analyzed by the GRADE. A meta-analysis was performed. Results Seven studies comprising 411 women with stress UI were included. Methodological quality ranged from 3 to 8 points. Treatment sessions varied from 5 to 45 min (PMFT) and 15 to 30 min (ES), from 4 weeks to 6 months. Studies varied regarding the type of electrical current and its characteristics. With very low certainty of evidence and severe risk of methodological bias, the meta-analysis showed that ES is not superior to supervised or unsupervised PFMT for any outcome. Conclusion ES is not superior to PFMT for reducing urinary leakage or improving quality of life in women with stress UI.