Home and outpatient electrostimulation in the treatment of urinary incontinence in women: a systematic review

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Abstract

Introduction and hypothesis

Urinary incontinence (UI) is defined as any involuntary loss of urine and can be associated with urgency and/or physical exertion. Electrical stimulation (ES) has recently been identified as a proven therapeutic alternative for UI, with few side effects and low cost. This systematic review, registered on the Prospective Register of Systematic Reviews (RD42024528812), investigated whether home-based ES would be as viable as outpatient ES in the treatment of women with UI.

Methods

Study selection was conducted by two independent researchers across the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Web of Science, Scopus, and PEDro (search conducted on February 25, 2024). We also searched the reference lists of eligible articles. There were no restrictions on date and language. The RoB2 and GRADE tools were used to assess methodological quality and evidence recommendation.

Results

723 articles were found, and four trials were eligible. Very low-quality evidence indicated statistically significant differences in cure rates or improvement of urinary symptoms in women treated with both outpatient and home-based ES. Low-quality evidence recommends home-based ES in maintaining improvement of urinary symptoms, and moderate-quality evidence indicates no severity of symptoms in the home-based group.

Conclusion

Home-based ES is shown to be as effective as outpatient ES in the treatment of UI in women. However, data analysis revealed low-quality evidence regarding the cure or improvement of the women’s conditions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-025-03568-8.

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The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

Matthew J L Page, Joanne E McKenzie, Patrick Bossuyt … (2027)

The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.

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The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials

Julian P. T. Higgins, Douglas G. Altman, Peter C. Gøtzsche … (2014)

Flaws in the design, conduct, analysis, and reporting of randomised trials can cause the effect of an intervention to be underestimated or overestimated. The Cochrane Collaboration’s tool for assessing risk of bias aims to make the process clearer and more accurate

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GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables.

Gordon Guyatt, Andrew D Oxman, Elie A. Akl … (2011)

This article is the first of a series providing guidance for use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system of rating quality of evidence and grading strength of recommendations in systematic reviews, health technology assessments (HTAs), and clinical practice guidelines addressing alternative management options. The GRADE process begins with asking an explicit question, including specification of all important outcomes. After the evidence is collected and summarized, GRADE provides explicit criteria for rating the quality of evidence that include study design, risk of bias, imprecision, inconsistency, indirectness, and magnitude of effect. Recommendations are characterized as strong or weak (alternative terms conditional or discretionary) according to the quality of the supporting evidence and the balance between desirable and undesirable consequences of the alternative management options. GRADE suggests summarizing evidence in succinct, transparent, and informative summary of findings tables that show the quality of evidence and the magnitude of relative and absolute effects for each important outcome and/or as evidence profiles that provide, in addition, detailed information about the reason for the quality of evidence rating. Subsequent articles in this series will address GRADE's approach to formulating questions, assessing quality of evidence, and developing recommendations. Copyright © 2011 Elsevier Inc. All rights reserved.

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Author and article information

Contributors

Clarcson Plácido Conceição dos Santos: clarcson@bahiana.edu.br

Journal

Journal ID (nlm-ta): BMC Womens Health

Journal ID (iso-abbrev): BMC Womens Health

Title: BMC Women's Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6874

Publication date (Electronic): 31 January 2025

Publication date PMC-release: 31 January 2025

Publication date Collection: 2025

Volume: 25

Electronic Location Identifier: 40

Affiliations

[1 ]Bahiana School of Medicine and Public Health, ( https://ror.org/0300yd604) Salvador, Brazil

[2 ]University of São Paulo, ( https://ror.org/036rp1748) Ribeirão Preto, Brazil

[3 ] Postgraduate Program in Medicine and Human Health, Bahiana School of Medicine and Public Health, ( https://ror.org/0300yd604) Rua Silveira Martins, nº 3386, Cabula, Salvador, BA 41150-000 Brazil

Article

Publisher ID: 3568

DOI: 10.1186/s12905-025-03568-8

PMC ID: 11783776

PubMed ID: 39885459

SO-VID: 41aa0b9b-f949-4d51-ae03-43ae57102542

License:

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

History

Date received : 23 September 2024

Date accepted : 16 January 2025

Custom metadata

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: urinary incontinence,transcutaneous electrical nerve stimulation,electroestimulation,women,systematic review

Data availability:

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: urinary incontinence, transcutaneous electrical nerve stimulation, electroestimulation, women, systematic review

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Home and outpatient electrostimulation in the treatment of urinary incontinence in women: a systematic review

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Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Supplementary Information

Related collections

Advocacy for Maternal and Women’s Health

Most cited references 38

The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials

GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables.

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Contributors

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Most referenced authors 1,208