[Meta-analysis of the efficacy of perineal rehabilitation for the treatment of female urinary stress incontinence].
OBJECTIVE
To determine with the highest level of evidence the efficacy of pelvic floor rehabilitation in the treatment of stress urinary incontinence in women.


METHODS
A systematic search was performed in the MEDLINE electronic database with the purpose to find randomised and controlled clinical trials evaluating the efficacy of pelvic floor rehabilitation in the treatment of stress urinary incontinence. A quantitative metanalysis was performed then by the Logit method combining the results from these studies to obtain an Odds ratio (OR) with its confidence interval. Moreover, it was determined the heterogeneity of the studies included in metanalysis by calculus of the Cochrane Q component.


RESULTS
8 randomised controlled clinical trials matched the inclusion criteria. Global OR resulting from the combination of these studies was 7.03 (Confidence interval 4.99-9.89). Nevertheless, the heterogeneity of the studies was significant, secondary among other circumstances to the fact that these studies did not establish the difference between improvement and cure clearly.


CONCLUSIONS
The heterogeneity of the studies does not allow to state after metanalysis (maximum level of scientific evidence) that pelvic floor rehabilitation is effective in the treatment of woman's stress urinary incontinence. Nevertheless two randomised controlled studies were found confirming that rehabilitation cures woman's stress urinary incontinence, from which there is good scientific evidence in favour of this treatment.
Vírseda Chamorro
Miguel
M
Servicio de Urología, Hospital Gómez Ulla, Madrid, España. bgmeli@nagasys.es
Salinas Casado
Jesús
J
Martín García
Carlos
C
D000328:Adult; D019317:Evidence-Based Medicine; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D016239:MEDLINE; D016017:Odds Ratio; D017773:Pelvic Floor; D010502:Perineum; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000534:rehabilitation* / Q000628:therapy; D014563:Urodynamics