Effect of conservative treatment of pelvic floor dysfunctions in women: an umbrella review

Abstract

Background: Due to their high worldwide prevalence, pelvic floor dysfunctions (PFD´s) are a public health problem. There is high heterogeneity in the types and effectiveness of conservative treatment. Objective: To analyze the scientific evidence on conservative treatment of PFDs in women. Search strategy: Umbrella review, covering MEDLINE (1950-2019), Scopus (1960-2019), Web of Science (1980-2019), and Cochrane Library (2000-2019). Selection criteria: Inclusion criterion: review on conservative treatments about pelvic floor disorders in the adult women, in Spanish or English; Exclusion criterion: studies about other urological, gynecological, and coloproctological pathologies, among others. Results: 32 reviews (2000 to 2019), 12 meta-analysis. 53.1% showed an improvement on urinary incontinence. Pelvic floor muscle training worked on 70.6% of them, followed by electrical stimulation and estrogen (11.7%), and weight loss (5.9%). 6.3% of reviews and meta-analyses fulfilled all items in PRISMA, and 93.7% of them fulfilled more than 60% of the checklist. 60% de los ítems. Conclusions: PFMT and weight loss are the most effective treatments for UI, but there is no evidence for other PFDs. The methodological quality of conservative treatments must be improved for a more effective treatment of PFDs in women.