Cochrane · systematic review · CD007471
Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women
Woodley, SJ, Lawrenson, P, Boyle, R, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
37
current version
GRADE rated
20
No studies
5
Included studies
NR
No studies 5 · 13.5%Ungraded 12 · 32.4%Very low 3 · 8.1%Low 8 · 21.6%Moderate 8 · 21.6%High 1 · 2.7%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyAntenatal pelvic floor muscle training compared to control for prevention of urinary and faecal incontinence
Population: pregnant women who were continent when randomised
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Urinary incontinence in late pregnancy Antenatal pelvic floor muscle training vs control | RR 0.38 [0.2, 0.72] | 6 studies · 624 participants | Moderate Downgraded: inconsistency |
Urinary incontinence mid‐postnatal period(> 3 to 6 months) Antenatal pelvic floor muscle training vs control | RR 0.71 [0.54, 0.95] | 5 studies · 673 participants | High |
Urinary incontinence late postnatal period(> 6 to 12 months) Antenatal pelvic floor muscle training vs control | RR 1.2 [0.65, 2.21] | 1 study · 44 participants | Low Downgraded: imprecision, inconsistency |
Faecal incontinence in late pregnancy Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Faecal incontinence mid‐postnatal period(> 3 to 6 months) Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Faecal incontinence late postnatal period(> 6 to 12 months) Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Urinary incontinence‐specific quality of life (ICIQ‐SF)Scale from: 0 to 10 (higher worse) Antenatal pelvic floor muscle training vs control | MD 2.42 | 1 study · 152 participants | Moderate Downgraded: imprecision, inconsistency |
Faecal incontinence‐specific quality of life Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse events Antenatal pelvic floor muscle training vs control | no estimate extracted | NR | No studies |
Antenatal pelvic floor muscle training compared to control for treatment of urinary and faecal incontinence
Population: pregnant women who were incontinent when randomised
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Urinary incontinence in late pregnancy Antenatal pelvic floor muscle training vs control | RR 0.7 [0.44, 1.13] | 3 studies · 345 participants | Very low Downgraded: risk of bias |
Urinary incontinence mid‐postnatal period(> 3‐6 months) Antenatal pelvic floor muscle training vs control | RR 0.94 [0.7, 1.24] | 1 study · 187 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Urinary incontinence late postnatal period(> 6‐12 months) Antenatal pelvic floor muscle training vs control | RR 0.5 [0.13, 1.93] | 2 studies · 869 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Faecal incontinence in late pregnancy Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Faecal incontinence mid‐postnatal period(> 3‐6 months) Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Faecal incontinence late postnatal period(> 6‐12 months) Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Urinary incontinence‐specific quality of life (ICIQ‐SF)Scale from: 0 to 10 (higher worse) Antenatal pelvic floor muscle training vs control | MD 3.5 | 1 study · 41 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Faecal incontinence‐specific quality of life Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse events Antenatal pelvic floor muscle training vs control | no estimate extracted | NR | No studies |
Antenatal pelvic floor muscle training compared to control for mixed prevention and treatment of urinary and faecal incontinence
Population: pregnant women, some of who were incontinent symptoms and some who were not when randomised
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Urinary incontinence in late pregnancy Antenatal pelvic floor muscle training vs control | RR 0.78 [0.64, 0.94] | 11 studies · 3307 participants | Moderate Downgraded: inconsistency |
Urinary incontinence mid‐postnatal period(> 3 to 6 months) Antenatal pelvic floor muscle training vs control | RR 0.73 [0.55, 0.97] | 5 studies · 1921 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Urinary incontinence late postnatal period(> 6 to 12 months) Antenatal pelvic floor muscle training vs control | RR 0.85 [0.63, 1.14] | 2 studies · 244 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Faecal incontinence in late pregnancy Antenatal pelvic floor muscle training vs control | RR 0.64 [0.36, 1.14] | 3 studies · 910 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Faecal incontinence mid‐postnatal period(> 3 to 6 months) Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Faecal incontinence late postnatal period(> 6 to 12 months) Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Urinary incontinence‐specific quality of life (ICIQ‐SF)Scale from: 0 to 10 (higher worse) Antenatal pelvic floor muscle training vs control | MD 0.2 | 1 study · 190 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Faecal incontinence‐specific quality of life (CRAIQ‐7) Antenatal pelvic floor muscle training vs control | MD 2.6 | 1 study · 74 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events Antenatal pelvic floor muscle training vs control | no estimate extracted | NR | No studies |
Postnatal pelvic floor muscle training compared to control for treatment of urinary and faecal incontinence
Population: postnatal women who were incontinent when randomised
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Urinary incontinence late postnatal period(> 6 to 12 months) Postnatal pelvic floor muscle training vs control | RR 0.55 [0.29, 1.07] | 3 studies · 696 participants | Low Downgraded: risk of bias |
Faecal incontinence late postnatal period(> 6 to 12 months) Postnatal pelvic floor muscle training vs control | RR 0.68 [0.24, 1.94] | 2 studies · 620 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Urinary incontinence‐specific quality of life(BFLUTS) Postnatal pelvic floor muscle training vs control | MD 1.66 | 1 study · 18 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Faecal incontinence‐specific quality of life Postnatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse events Postnatal pelvic floor muscle training vs control | no estimate extracted | NR | No studies |
Postnatal pelvic floor muscle training compared to control for mixed prevention and treatment of urinary and faecal incontinence
Population: postnatal women some of whom had incontinent symptoms and some of whom had not when randomised
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Urinary incontinence late postnatal period(> 6 to 12 months) Postnatal pelvic floor muscle training vs control | RR 0.88 [0.71, 1.09] | 3 studies · 826 participants | Moderate Downgraded: inconsistency |
Faecal incontinence late postnatal period(> 6 to 12 months) Postnatal pelvic floor muscle training vs control | RR 0.73 [0.13, 4.21] | 1 study · 107 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Urinary incontinence‐specific quality of life (IIQ‐7)Scale from: 0 to 100 (higher worse) Postnatal pelvic floor muscle training vs control | MD 0.5 | 1 study · 23 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Faecal incontinence‐specific quality of life (FIQOL scale) Postnatal pelvic floor muscle training vs control | no estimate extracted | 2 studies · 170 participants | Ungraded |
Adverse events Postnatal pelvic floor muscle training vs control | no estimate extracted | NR | No studies |
Antenatal pelvic floor muscle training compared to control for prevention of urinary and faecal incontinence
Population: pregnant women who were continent when randomised
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Urinary incontinence in late pregnancy Antenatal pelvic floor muscle training vs control | RR 0.38 [0.2, 0.72] | 6 studies · 624 participants | Low Downgraded: imprecision, inconsistency |
Urinary incontinence mid‐postnatal period (> 3‐6 months) Antenatal pelvic floor muscle training vs control | RR 0.71 [0.54, 0.95] | 5 studies · 673 participants | Moderate Downgraded: imprecision, inconsistency |
Urinary incontinence late postnatal period (> 6‐12 months) Antenatal pelvic floor muscle training vs control | RR 1.2 [0.65, 2.21] | 1 study · 44 participants | Low Downgraded: imprecision, inconsistency |
Faecal incontinence in late pregnancy Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Faecal incontinence mid‐postnatal period (> 3‐6 months) Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Faecal incontinence late postnatal period (> 6‐12 months) Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Incontinence‐specific quality of life Antenatal pelvic floor muscle training vs control | MD 2.42 | 1 study · 152 participants | Moderate Downgraded: imprecision, inconsistency |
Antenatal pelvic floor muscle training compared to control for treatment of urinary and faecal incontinence
Population: pregnant women who were incontinent when randomised
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Urinary incontinence in late pregnancy Antenatal pelvic floor muscle training vs control | RR 0.7 [0.44, 1.13] | 3 studies · 345 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Urinary incontinence mid‐postnatal period (> 3‐6 months) Antenatal pelvic floor muscle training vs control | RR 0.94 [0.7, 1.24] | 1 study · 187 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Urinary incontinence late postnatal period (> 6‐12 months) Antenatal pelvic floor muscle training vs control | RR 0.5 [0.13, 1.93] | 2 studies · 869 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Faecal incontinence in late pregnancy Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Faecal incontinence mid‐postnatal period (> 3‐6 months) Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Faecal incontinence late postnatal period (> 6‐12 months) Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Incontinence‐specific quality of life (ICIQ‐SF) Scale from: 0 to 10 (worse) Antenatal pelvic floor muscle training vs control | MD 3.5 | 1 study · 41 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Antenatal pelvic floor muscle training compared to control for mixed prevention and treatment of urinary and faecal incontinence
Population: pregnant women some of who were incontinent symptoms and some who were not when randomised
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Urinary incontinence in late pregnancy Antenatal pelvic floor muscle training vs control | RR 0.74 [0.61, 0.9] | 9 studies · 3164 participants | Low Downgraded: inconsistency, indirectness |
Urinary incontinence mid‐postnatal period (> 3‐6 months) Antenatal pelvic floor muscle training vs control | RR 0.73 [0.55, 0.97] | 5 studies · 1921 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Urinary incontinence late postnatal period (> 6‐12 months) Antenatal pelvic floor muscle training vs control | RR 0.85 [0.63, 1.14] | 2 studies · 244 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Faecal incontinence in late pregnancy Antenatal pelvic floor muscle training vs control | RR 0.61 [0.3, 1.25] | 2 studies · 867 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Faecal incontinence mid‐postnatal period (> 3‐6 months) Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Faecal incontinence late postnatal period (> 6‐12 months) Antenatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |
Incontinence‐specific quality of life late postnatal period (> 6‐12 months) (ICIQ‐SF) Scale from: 0 to 10 (worse) Antenatal pelvic floor muscle training vs control | MD 0.2 | 1 study · 190 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Postnatal pelvic floor muscle training compared to control for treatment of urinary and faecal incontinence
Population: postnatal women who were incontinent when randomised
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Urinary incontinence late postnatal period (> 6‐12 months) Postnatal pelvic floor muscle training vs control | RR 0.55 [0.29, 1.07] | 3 studies · 696 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
Faecal incontinence late postnatal period (> 6‐12 months) Postnatal pelvic floor muscle training vs control | RR 0.68 [0.24, 1.94] | 2 studies · 620 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Incontinence‐specific quality of life Postnatal pelvic floor muscle training vs control | MD 1.66 | 1 study · 18 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Postnatal pelvic floor muscle training compared to control for mixed prevention and treatment of urinary and faecal incontinence
Population: postnatal women some of whom had incontinent symptoms and some of whom had not when randomised
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Urinary incontinence late postnatal period (> 6‐12 months) Postnatal pelvic floor muscle training vs control | RR 0.88 [0.71, 1.09] | 3 studies · 826 participants | Very low Downgraded: imprecision, inconsistency |
Faecal incontinence late postnatal period (> 6‐12 months) Postnatal pelvic floor muscle training vs control | RR 0.73 [0.13, 4.21] | 1 study · 107 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Incontinence‐specific quality of life Postnatal pelvic floor muscle training vs control | no estimate extracted | 0 studies · 0 participants | Ungraded |