Intravaginal electrical stimulation as a monotherapy for female stress urinary incontinence: A systematic review and meta-analysis

Background and purpose: Since patients, physiotherapists and gynaecologists continue to seek effective conservative treatments for stress urinary incontinence (SUI), the aim of this systematic review and meta-analysis was to determine the therapeutic efficacy of intravaginal electrical stimulation (ES) in women with SUI. Methods: We searched PubMed, Embase, EBSCOHost and Ovid for randomized controlled trials. For dichotomous data, we calculated the risk ratio (RR) and 95% confidence interval (CI). For continuous data, we calculated the mean difference (MD) and 95% CI. Heterogeneity was assessed with I2 statistics. Results: Of the 686 records identified, a total of 10 articles met the inclusion criteria. A meta-analysis revealed significant differences between the ES and no active treatment groups in the pooled objective cure rates (RR: 4.20; 95% CI: 1.70 to 10.40; p = 0.001; I-2 = 0%) and subjective cure or improvement rates (RR: 4.96; 95%: 1.01 to 24.37; p = 0.04; I-2 = 0%). No significant differences were found in the pooled number of incontinence episodes per 24 h (MD: 0.16; 95% CI: 0.68 to 0.37; p = 0.56; I-2 = 0%), the pooled Incontinence Quality of Life Questionnaire scores (MD: 1.84; 95% CI: 2.11 to 5.80; p = 0.36; I-2 = 0%) or the pooled number of adverse effects (RR: 0.69; 95% CI: 0.38 to 1.27; p = 0.23; I-2 = 0%) between the ES and other conservative treatment groups. Conclusion: There was insufficient evidence for or against the use of intravaginal ES therapy for women with SUI, partly due to the variability in the interventions of the included trials and the small number of trials included.