ArticleTherapeutic advances in urology
The effectiveness of invasive and non-invasive biofeedback-assisted pelvic floor muscle training with or without electrical stimulation for the treatment of stress urinary incontinence in women: a systematic review with meta-analysis and meta-regression of randomized controlled trials.
Article in Therapeutic advances in urology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Previous reviews evaluating biofeedback (BF)-assisted pelvic floor muscle (PFM) training (PFMT) with or without electrical stimulation (ES) for women with stress urinary incontinence (SUI) have reported conflicting results, and no consensus has been reached on the optimal parameters for this intervention. Objectives: To (1) evaluate the effectiveness of non-invasive and invasive BF-assisted PFMT with or without ES for SUI in women and (2) investigate whether study design characteristics and intervention parameters affect treatment effects. Design: Systematic review with meta-analysis and meta-regression. Data sources and methods: Seven English and two Chinese databases were searched from inception to May 2025. Outcomes were synthesized as standardized mean differences (SMDs) or odds ratios (ORs) with 95% confidence intervals. Meta-regression was employed to investigate the impact of study design characteristics and intervention parameters on outcomes. Results: This review included 21 studies involving 2373 participants. Meta-analyses revealed significant effects of invasive BF-assisted PFMT on PFM strength (SMD 0.71 (0.29, 1.14), Conclusion: Invasive BF-assisted PFMT can improve PFM strength, reduce urine loss and UI symptom severity, enhance QoL, and increase the improvement/cure rate. Non-invasive BF-assisted PFMT can reduce urine loss severity. However, these results must be interpreted cautiously due to methodological flaws, risks of bias, and substantial heterogeneity across the included studies. Further high-quality studies are warranted to confirm the effectiveness of invasive or non-invasive BF-assisted PFMT with or without ES for treating SUI in women. The recommended parameters may optimize treatment effects. Trial registration: PROSPERO (CRD42023473798).
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