Biofeedback for the treatment of female pelvic floor muscle dysfunction: a systematic review and meta-analysis

Biofeedback for the treatment of female pelvic floor muscle dysfunction: a systematic review and meta-analysis

Author Fitz, Fatima Fani Autor UNIFESP Google Scholar
Magalhaes Resende, Ana Paula Autor UNIFESP Google Scholar
Stuepp, Liliana Autor UNIFESP Google Scholar
Ferreira Sartori, Marair Gracio Autor UNIFESP Google Scholar
Batista Castello Girao, Manoel Joao Autor UNIFESP Google Scholar
Castro, Rodrigo Aquino Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Biofeedback (BF) has been widely used in the treatment of pelvic floor dysfunctions, mainly by promoting patient learning about muscle contraction with no side effects. However, its effectiveness remains poorly understood with some studies suggesting that BF offers no advantage over the isolated pelvic floor muscle training (PFMT). the main objective of this study was to systematically review available randomized controlled trials assessing the effectiveness of BF in female pelvic floor dysfunction treatment. Trials were electronically searched and rated for quality by use of the PEDro scale (values of 0-10). Randomized controlled trials assessing the training of pelvic floor muscle (PFM) using BF in women with PFM dysfunction were selected. Outcomes were converted to a scale ranging from 0 to 100. Trials were pooled with software used to prepare and update Cochrane reviews. Results are presented as weighted mean differences with 95 % confidence intervals (CI). Twenty-two trials with 1,469 patients that analyzed BF in the treatment of urinary, anorectal, and/or sexual dysfunctions were included. PFMT alone led to a superior but not significant difference in the function of PFM when compared to PFMT with BF, by using vaginal measurement in the short and intermediate term: 9.89 (95 % CI -5.05 to 24.83) and 15.03 (95 % CI -9.71 to 39.78), respectively. We found a few and nonhomogeneous studies addressing anorectal and sexual function, which do not provide the cure rate calculations. Limitations of this review are the low quality and heterogeneity of the studies, involving the usage of distinct protocols of interventions, and various and different outcome measures. the results of this systematic review suggest that PFMT with BF is not more effective than other conservative treatments for female PFM dysfunction.
Keywords Biofeedback
Pelvic floor muscle
Urinary incontinence
Fecal incontinence
Sexual dysfunction
Language English
Sponsor Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Grant number CNPq: 153287/2010-1
Date 2012-11-01
Published in International Urogynecology Journal. London: Springer London Ltd, v. 23, n. 11, p. 1495-1516, 2012.
ISSN 0937-3462 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 1495-1516
Access rights Closed access
Type Review
Web of Science ID WOS:000310469800003

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