Comparative effectiveness of nonsurgical treatment for stress urinary incontinence in adult women: a systematic review and network meta-analysis of randomized controlled trials

Objective: This study aimed to explore the most effective nonsurgical therapy to treat stress urinary incontinence (SUI). Methods: Data were pooled and the Bayesian random effects model was utilized to evaluate the inconsistencies between indirect and direct proof. Network sub-analyses, sensitivity and subgroup analysis, and standard pairwise comparisons were utilized in preparation of the main analysis. Results: A total of 17 RCTs (852 participants) were enrolled. With regard to therapy, pelvic floor muscle training (PFMT) was more often recommended than biofeedback (BF). The combination of PFMT and BF was remarkably promoted than PFMT alone or PFMT with vaginal cone (VC) or electrical stimulation (ES). The QL scores of patients who underwent PFMT were noticeably improved compared with those of patients who underwent ES. The combination of BF and PFMT was remarkably promoted compared with BF alone. VC was superior to ES with regard to QL scores. By contrast, ES alone was the least preferred method to decrease urine leakage and to promote QL. Conclusion: The combination of BF and PFMT was proven to be an optimal method to treat SUI which aims to promote urine leakage and LQ compared with either PFMT alone, ES, VC, or circular muscle (CME), while ES was the least preferred method to promote LQ.