title: Mechanical devices for urinary incontinence in women.
abstract: BACKGROUND
  Incontinence can have a devastating effect on the lives of sufferers with significant economic implications. Non-surgical treatments such as pelvic floor muscle training and the use of mechanical devices are usually the first line of management. The latter more so when a person did not want surgery or when considered unfit for surgery. Mechanical devices are inexpensive and do not compromise future surgical treatment.
  
  
  OBJECTIVE
  To determine the effects of mechanical devices in the management of adult female urinary incontinence.
  
  
  METHODS
  We searched the Cochrane Incontinence Group Specialised Trials Register (7 December 2005). The register contains trials identified from MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL and handsearching of journals and conference proceedings.
  
  
  METHODS
  All randomised or quasi-randomised controlled trials of mechanical devices in the management of adult female urinary incontinence determined either by symptom classification or by urodynamic diagnosis.
  
  
  METHODS
  Three reviewers assessed the identified studies for eligibility and methodological quality and independently extracted data from the included studies. Data analysis was performed using RevMan software (version 4.2).
  
  
  RESULTS
  There were six trials involving a total of 286 women. Two small trials compared a mechanical device with no treatment and although they suggested that use of a mechanical device might be better than no treatment, the evidence for this was inconclusive. Five trials compared one mechanical device with another. Quantitative synthesis of data from these trials was not possible because different mechanical devices were compared in each trial using different outcome measures. Data from the individual trials showed no clear difference between devices, but with wide confidence intervals. There were no trials comparing a mechanical device with another type of treatment.
  
  
  CONCLUSIONS
  The place of mechanical devices in the management of urinary incontinence remains in question. Currently there is little evidence from controlled trials on which to judge whether their use is better than no treatment and a large well-conducted trial is required for clarification. There was also insufficient evidence in favour of one device over another and no evidence to compare mechanical devices with other forms of treatment.
authors.affiliation: Aberdeen Royal Infirmary, Department of Urology, NHS Grampian, Aberdeen, United Kingdom, AB25 2ZN. shafaque.shaikh@nhs.net
authors.forename: S
authors.initials: S
authors.lastname: Shaikh
authors.forename: E K
authors.initials: EK
authors.lastname: Ong
authors.forename: K
authors.initials: K
authors.lastname: Glavind
authors.forename: J
authors.initials: J
authors.lastname: Cook
authors.forename: J M O
authors.initials: JM
authors.lastname: N'Dow
mesh_terms: D005260:Female; D006801:Humans; D010570:Pessaries; D019736:Prostheses and Implants; D016032:Randomized Controlled Trials as Topic; D013630:Tampons, Surgical; D014549:Urinary Incontinence / Q000534:rehabilitation*; D016741:Urinary Sphincter, Artificial