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Q In women with urinary incontinence, which management strategies are effective?
Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Geriatrics ★★★★★☆☆ Gynaecology ★★★★★☆☆
METHODS
Data sources:
Medline, EMBASE/Excerpta Medica, the Cochrane Library, and the ACP Journal Club (all between January 1998 and March 2003), bibliographies of relevant articles, and experts.
Study selection and assessment:
randomised controlled trials (RCTs) or systematic reviews of RCTS in the English language that focused on the treatment of urinary incontinence in women. Studies of oestrogen or hormone replacement therapy were excluded. Studies were assessed for blinding, random allocation, concealment, description of withdrawals, presence of clinically relevant outcomes, and intention to treat analysis.
Outcomes:
clinical outcomes including cure or improvement in urinary incontinence and frequency of incontinent episodes.
MAIN RESULTS
66 studies were included, of which 34 were treatment studies. A Cochrane review of trials in stress, urge, and mixed incontinence reported that pelvic floor muscle training (PFMT) increased self reported cure or improvement more than no treatment (relative risk [RR] 23.0, 95% CI 7.6 to 70.2) or placebo (RR 1.5, CI 1.3 to 1.9). 1 RCT in women …
Footnotes
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For correspondence: Dr J M Holroyd-Leduc, Toronto General Hospital, Toronto, Ontario, Canada. jayna.holroyd-leducuhn.on.ca
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Sources of funding: Veterans Affairs and Ontario Ministry of Health and Long-term Care.