Aims: To examine the effectiveness of extracorporeal magnetic stimulation for treatment of stress urinary incontinence.
Design: Systematic review and meta-analysis.
Data resources: Four electronic databases from inception to 18 May 2019.
Review methods: Two authors independently performed the search, assessed the methodological quality, and extracted data. The final studies included in the analysis were selected after reaching consensus with the third author.
Results: A total of 20 studies were included in the systematic review and 12 of these in the meta-analysis. Quality assessment indicated that only 8 of 17 randomized controlled trials had low risk in overall risk of bias, whereas all controlled trials had serious risk of bias. The weighted mean effect size of magnetic stimulation on quality of life, number of leakages, pad test outcomes, and number of incontinence events was 1.045 (95% CI: 0.409-1.681), -0.411 (95% CI: 0.178-0.643), -0.290 (95% CI: 0.025-0.556), and -0.747 (95% CI: -1.122 to -0.372), respectively. Subgroup analysis revealed a significant difference in the type of quality of life measurement used. Sensitivity analyses revealed that a high degree of heterogeneity persisted even after omitting studies individually.
Conclusions: Extracorporeal magnetic stimulation may be effective in treating urinary incontinence and improving quality of life without major safety concerns. However, because of a high degree of heterogeneity among studies, inferences from the results must be made with caution.
Impact: We recommend that clinical nurses apply extracorporeal magnetic stimulation to treat stress urinary incontinence among female patients and encourage researchers to conduct further qualitative and quantitative studies to develop consistent content and dosage for the intervention.
Study registration: The review protocol was registered a priori and published online in the PROSPERO database of systematic reviews (www.crd.york.ac.uk/Prospero with the registration number #CRD42019138835).
目的: 探讨体外磁刺激治疗压力性尿失禁的疗效。 设计: 系统评估和荟萃分析 数据来源: 从研究开始到2019年5月18日的四个电子数据库。 评估方法: 两位作者独立展开检索,评估了方法质量,并提取了数据。在与第三位作者达成共识后,选择了最终纳入分析的研究。 结果: 系统评估中共纳入20项研究,其中12项纳入荟萃分析。质量评估显示,17项随机对照试验中只有8项总体偏倚风险较低,而所有对照试验均存在严重偏倚风险。磁刺激对生活质量、漏尿次数、护垫试验结果和尿失禁事件次数的加权平均效应量分别为1.045(95% CI:0.409˜1.681)、−0.411 (95% CI: 0.178-0.643)、-0.290(95% CI:0.025˜0.556)和-0.747(95% CI:-1.122˜-0.372)。子组分析显示,所使用的生活质量衡量指标类型存在显著差异。 敏感性分析显示,即使省略个别研究后,仍存在高度异质性。 结论: 体外磁刺激可有效治疗尿失禁,提高生活质量,且无重大安全隐患。然而,由于研究之间的高度异质性,必须谨慎地从结果中作出推断。 影响: 我们建议临床护士应用体外磁刺激治疗女性患者压力性尿失禁,并鼓励研究人员进一步开展定性和定量研究,以确定一致性干预内容和剂量。 研究登记: 评估方案已事先登记,并在PROSPERO系统性评估数据库中在线发布(www.crd.york.ac.uk/Prospero,登记号为#CRD42019138835)。.
Keywords: clinical interventional; clinical nursing staffs; extracorporeal magnetic stimulation; meta-analysis; nurse; nursing; quality of life; randomized control trial; systematic review; urinary incontinence.
© 2020 John Wiley & Sons Ltd.