Efficacy of telemedicine for urinary incontinence in women: a systematic review and meta-analysis of randomized controlled trials

Objectives The systematic review and meta-analysis were performed to summarize the available evidence and assess the efficacy of telemedicine for urinary incontinence in women. Methods PUBMED, EMBASE, Web of Science, The Cochrane Library, CBM, CNKI, WanFang, and VIP databases were electronically searched to identify eligible studies updated to February 2020 to collect RCTs regarding the efficacy of telemedicine for urinary incontinence in women. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of included studies with the Cochrane Handbook for Systematic Reviews of Interventions. A meta-analysis was performed using RevMan 5.3. Results Seven studies involving a total of 836 patients were included in the systematic review and meta-analysis. The results of the meta-analysis showed that compared with usual care, telemedicine intervention significantly reduced the UI severity (SMD = -0.90, 95% CI, -1.73 - -0.07, P = 0.003) and improved QOL (SMD = 0.71, 95% CI, 0.21-1.20, P = 0.005). The results of the descriptive analysis indicated that telemedicine intervention can also reduce the patients' anxiety and depression, improving patients' self-efficacy and their impression of improvement. Conclusion The systematic review and meta-analysis demonstrate that telemedicine can reduce the UI severity and anxiety and depression, improving QOL, self-efficacy, and impression of improvement for women with urinary incontinence. Due to the limited quality and quantity of the included studies, rigorous studies with adequate sample sizes are required to conclude with more confidence.