Cochrane · systematic review · CD012390
Electrical stimulation with non‐implanted devices for stress urinary incontinence in women
Stewart, F, Berghmans, B, Bø, K, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
IncontinenceAMSTAR 2: not assessed
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
55
current version
GRADE rated
31
No studies
24
Included studies
NR
No studies 24 · 43.6%Ungraded 0 · 0%Very low 11 · 20%Low 18 · 32.7%Moderate 2 · 3.6%High 0 · 0%
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
Electrical stimulation versus no active treatment
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cure: number of women with self‐reported continence Electrical stimulation vs no active treatment | RR 2.31 [1.06, 5.02] | 2 studies · 101 participants | Moderate Downgraded: imprecision |
Improvement: number of women with self‐reported improvement in SUI (cured or improved) Electrical stimulation vs no active treatment | RR 1.73 [1.41, 2.11] | 5 studies · 347 participants | Low Downgraded: risk of bias, imprecision |
Incontinence‐specific quality of life (higher score = worse quality of life) Electrical stimulation vs no active treatment | no estimate extracted | 4 studies · 250 participants | Moderate Downgraded: risk of bias |
Adverse effects Electrical stimulation vs no active treatment | RR 5.96 [0.3, 118.7] | 3 studies · 103 participants | Very low Downgraded: risk of bias, imprecision |
Cost‐effectiveness Electrical stimulation vs no active treatment | no estimate extracted | NR | No studies |
Electrical stimulation versus sham treatment
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cure: number of women with self‐reported continence Electrical stimulation vs sham treatment | RR 2.21 [0.38, 12.73] | 3 studies · 158 participants | Very low Downgraded: risk of bias, imprecision |
Improvement: number of women with self‐reported improvement in SUI (cured or improved) Electrical stimulation vs sham treatment | RR 2.03 [1.02, 4.07] | 5 studies · 236 participants | Low Downgraded: risk of bias |
Incontinence‐specific quality of life Electrical stimulation vs sham treatment | no estimate extracted | 2 studies · 117 participants | Low Downgraded: imprecision |
Adverse effects Electrical stimulation vs sham treatment | RR 2.01 [0.52, 7.67] | 4 studies · 233 participants | Low Downgraded: imprecision |
Cost‐effectiveness Electrical stimulation vs sham treatment | no estimate extracted | NR | No studies |
Electrical stimulation versus pelvic floor muscle training
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cure: number of women with self‐reported continence Electrical stimulation vs pelvic floor muscle training | RR 0.51 [0.16, 1.63] | 4 studies · 143 participants | Low Downgraded: risk of bias, imprecision |
Improvement: number of women with self‐reported improvement in SUI (cured or improved) Electrical stimulation vs pelvic floor muscle training | RR 0.85 [0.7, 1.03] | 7 studies · 244 participants | Low Downgraded: risk of bias, imprecision |
Incontinence‐specific quality of life Electrical stimulation vs pelvic floor muscle training | no estimate extracted | 2 studies · 93 participants | Low Downgraded: risk of bias, imprecision |
Adverse effects Electrical stimulation vs pelvic floor muscle training | RR 5 [0.25, 99.16] | 3 studies · 121 participants | Low Downgraded: imprecision |
Cost‐effectiveness Electrical stimulation vs pelvic floor muscle training | no estimate extracted | NR | No studies |
Electrical stimulation versus vaginal cones
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cure: number of women with self‐reported continence Electrical stimulation vs vaginal cones | RR 1.04 [0.7, 1.54] | 3 studies · 157 participants | Low Downgraded: risk of bias, imprecision |
Subjective cure or improvement Electrical stimulation vs vaginal cones | RR 1.09 [0.97, 1.21] | 5 studies · 331 participants | Low Downgraded: risk of bias, imprecision |
Incontinence‐specific quality of life Electrical stimulation vs vaginal cones | no estimate extracted | 2 studies · 96 participants | Low Downgraded: risk of bias, imprecision |
Adverse effects Electrical stimulation vs vaginal cones | RR 0.54 [0.11, 2.7] | 1 study · 52 participants | Low Downgraded: risk of bias, imprecision |
Cost‐effectiveness Electrical stimulation vs vaginal cones | no estimate extracted | NR | No studies |
Electrical stimulation versus PFMT plus vaginal cones
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cure: number of women with self‐reported continence Electrical stimulation vs PFMT plus vaginal cones | RR 1.45 [0.96, 2.2] | 2 studies · 123 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Subjective cure or improvement Electrical stimulation vs PFMT plus vaginal cones | RR 1.53 [1.08, 2.18] | 2 studies · 123 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Incontinence‐specific quality of life Electrical stimulation vs PFMT plus vaginal cones | no estimate extracted | NR | No studies |
Adverse effects Electrical stimulation vs PFMT plus vaginal cones | no estimate extracted | NR | No studies |
Cost‐effectiveness Electrical stimulation vs PFMT plus vaginal cones | no estimate extracted | NR | No studies |
Electrical stimulation versus drug therapy
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cure: number of women with self‐reported continence Electrical stimulation vs drug therapy | no estimate extracted | NR | No studies |
Subjective cure or improvement Electrical stimulation vs drug therapy | RR 13.89 [0.84, 230.82] | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision |
Incontinence‐specific quality of life Electrical stimulation vs drug therapy | no estimate extracted | NR | No studies |
Adverse effects Electrical stimulation vs drug therapy | no estimate extracted | NR | No studies |
Cost‐effectiveness Electrical stimulation vs drug therapy | no estimate extracted | NR | No studies |
Electrical stimulation plus PFMT versus PFMT
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cure: number of women with self‐reported continence Electrical stimulation plus PFMT vs PFMT | RR 0.76 [0.38, 1.52] | 3 studies · 99 participants | Low Downgraded: risk of bias, imprecision |
Improvement: number of women with self‐reported improvement in SUI (cured or improved) Electrical stimulation plus PFMT vs PFMT | RR 1.1 [0.95, 1.28] | 6 studies · 308 participants | Low Downgraded: risk of bias |
Incontinence‐specific quality of life (higher score = worse quality of life) Electrical stimulation plus PFMT vs PFMT | no estimate extracted | 4 studies · 193 participants | Very low Downgraded: risk of bias |
Adverse effects Electrical stimulation plus PFMT vs PFMT | no estimate extracted | 1 study · 133 participants | Low Downgraded: risk of bias, imprecision |
Cost‐effectiveness Electrical stimulation plus PFMT vs PFMT | no estimate extracted | NR | No studies |
Electrical stimulation plus surgery versus surgery
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cure: number of women with self‐reported continence Electrical stimulation plus surgery vs surgery | RR 1.19 [0.53, 2.67] | 1 study · 120 participants | Very low Downgraded: risk of bias, imprecision |
Improvement: number of women with self‐reported improvement in SUI (cured or improved) Electrical stimulation plus surgery vs surgery | RR 5.36 [0.61, 47.36] | 1 study · 120 participants | Very low Downgraded: risk of bias, imprecision |
Incontinence‐specific quality of life Electrical stimulation plus surgery vs surgery | no estimate extracted | 1 study · 120 participants | Low Downgraded: risk of bias, imprecision |
Adverse effects Electrical stimulation plus surgery vs surgery | RR 1 [0.37, 2.72] | 1 study · 120 participants | Very low Downgraded: risk of bias, imprecision |
Cost‐effectiveness Electrical stimulation plus surgery vs surgery | no estimate extracted | NR | No studies |
Surface ES versus intravaginal ES
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cure: number of women with self‐reported continence Surface ES vs intravaginal ES | no estimate extracted | NR | No studies |
Improvement: number of women with self‐reported improvement in SUI (cured or improved) Surface ES vs intravaginal ES | no estimate extracted | NR | No studies |
Incontinence‐specific quality of life Surface ES vs intravaginal ES | no estimate extracted | 1 study · 30 participants | Low Downgraded: imprecision |
Adverse effects Surface ES vs intravaginal ES | no estimate extracted | NR | No studies |
Cost‐effectiveness Surface ES vs intravaginal ES | no estimate extracted | NR | No studies |
Low intensity ES plus PFMT versus maximal intensity ES plus PFMT
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cure: number of women with self‐reported continence Low intensity ES plus PFMT vs maximal intensity ES plus PFMT | no estimate extracted | NR | No studies |
Improvement: number of women with self‐reported improvement in SUI (cured or improved) Low intensity ES plus PFMT vs maximal intensity ES plus PFMT | RR 0.28 [0.09, 0.91] | 1 study · 49 participants | Low Downgraded: imprecision |
Incontinence‐specific quality of life Low intensity ES plus PFMT vs maximal intensity ES plus PFMT | no estimate extracted | NR | No studies |
Adverse effects ‐ not reported Low intensity ES plus PFMT vs maximal intensity ES plus PFMT | no estimate extracted | NR | No studies |
Cost‐effectiveness ‐ not reported Low intensity ES plus PFMT vs maximal intensity ES plus PFMT | no estimate extracted | NR | No studies |
Conventional ES plus PFMT versus dynamic ES plus PFMT
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cure: number of women with self‐reported continence Conventional ES plus PFMT vs dynamic ES plus PFMT | no estimate extracted | NR | No studies |
Improvement: number of women with self‐reported improvement in SUI (cured or improved) (perception of bother of UI symptoms) Conventional ES plus PFMT vs dynamic ES plus PFMT | no estimate extracted | 1 study · 61 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Incontinence‐specific quality of life Conventional ES plus PFMT vs dynamic ES plus PFMT | no estimate extracted | 1 study · 61 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse effects ‐ not reported Conventional ES plus PFMT vs dynamic ES plus PFMT | no estimate extracted | NR | No studies |
Cost‐effectiveness ‐ not reported Conventional ES plus PFMT vs dynamic ES plus PFMT | no estimate extracted | NR | No studies |