The Experience of Women From Underrepresented Groups With Urinary Incontinence: A Systematic Review.
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ABSTRACT: Introduction
Urinary incontinence (UI) in women is a global public health issue. However, there is a limited understanding of the experience of women from underrepresented groups suffering from UI. The purpose of this systematic review was to examine current evidence regarding the experience of women with UI from these groups.Methodology
A systematic search was undertaken to retrieve research studies that answered the research question. Four qualitative research studies were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review.Results
Four themes emerged from this review: the perceived origin of UI, the physical, psychological, and social impact of UI, the impact of culture and religion on UI, and vice versa, and the interaction of women with health services.Discussion
Social determinants of health, such as religion and culture, need to be considered by professionals providing care if women from underrepresented groups experiencing UI are to receive optimal care.
SUBMITTER: Blanco Gutierrez V
PROVIDER: S-EPMC10265309 | biostudies-literature | 2023 Jul
REPOSITORIES: biostudies-literature
Publications
The Experience of Women From Underrepresented Groups With Urinary Incontinence: A Systematic Review.
Blanco Gutiérrez Verónica V Hundley Vanora A VA Way Susan S
Journal of transcultural nursing : official journal of the Transcultural Nursing Society 20230518 4
<h4>Introduction</h4>Urinary incontinence (UI) in women is a global public health issue. However, there is a limited understanding of the experience of women from underrepresented groups suffering from UI. The purpose of this systematic review was to examine current evidence regarding the experience of women with UI from these groups.<h4>Methodology</h4>A systematic search was undertaken to retrieve research studies that answered the research question. Four qualitative research studies were incl ...[more]
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Project description:BackgroundMixed urinary incontinence increasingly undermines women's quality of life. Previous studies showed some effects of acupuncture for MUI, but no systematic review has been done to evaluate the efficacy and safety of acupuncture for MUI in women.ObjectiveTo systematically review the efficacy and safety of acupuncture for women with MUI.MethodsTen databases (i.e., PubMed, Web of Science, Embase, ClinicalTrials.gov, the Cochrane Library, CBM, Scoups, CNKI, VIP and WANFANG DATA) were searched up to July 19th, 2021, using tailored search strategies with keywords not limited to "female," "mixed urinary incontinence," "acupuncture," and "randomized controlled trial," etc. RCTs and quasi-RCTs were included if investigating effect of any type of acupuncture for female patients with MUI. Data were extracted from eligible studies, and risks of bias were assessed according to the Cochrane Handbook from seven aspects using the RevMan 5.4 software.ResultsA total of three randomized studies with 591 women were included. The risk of bias among the studies varied, with major concerns on blinding of participants and outcome assessor. Liu's study (497) mainly showed that electroacupuncture's effect on reduction of numbers of incontinence, urgency, nocturia episodes, and amount of urine leakage etc. was not inferior to that of PFMT-Solifenacin group at 12, 24, and 36 weeks. Zhan's study (60) showed that electroacupuncture reduced significantly more amount of urine leakage than Tolterodine at 8 weeks, with no data on incontinence episodes frequency. All 3 studies reported that acupuncture significantly increased the quality of life assessed by ICIQ score. In addition, incidence of acupuncture-related adverse events was rare, while antimuscarinic agents related adverse events were common in two studies.ConclusionAlthough acupuncture showed some benefit for women with MUI, more evidences were required to draw a solid conclusion of effectiveness and safety of acupuncture for women with MUI.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021224600.
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Project description:BackgroundSurgical interventions for the treatment of stress urinary incontinence (SUI) in women are commonly employed following the failure of minimally invasive therapies. Due to the limited information available on the relative cost-effectiveness of available surgeries for treating SUI, a de novo economic analysis was conducted to assess costs and effects of all relevant surgeries. To inform the economic analysis, the objective of this review was to identify and assess the quality of existing economic evaluation studies on different surgical interventions for the treatment of SUI in women.MethodsThe following databases were searched during the review process: Medical Literature Analysis and Retrieval System Online (MEDLINE), MEDLINE In-Process, Excerpta Medica Database (Embase), National Health Service Economic Evaluation Database (NHS EED), and Health Management Information Consortium and Cost-Effectiveness Analysis Registry (CEA registry). The key criteria for inclusion were that the study population included women with SUI and that the surgical interventions considered were utilised as either a primary or a follow-up surgery. The review included only full economic evaluations. Studies were quality assessed using the Drummond checklist for economic evaluations. No quantitative synthesis of the results by meta-analysis was conducted due to the high methodological heterogeneity.ResultsTwenty-six economic evaluations were included, of which 13 were model-based analyses. Surgical treatments assessed most frequently were mid-urethral slings and open and laparoscopic colposuspension. There were some differences in the methodological approaches taken, including differences in type of economic analysis, perspective, time horizon, types of resource use, and costs and outcomes that were included in the analysis. The majority of studies conducted a cost-utility analysis from a health system perspective and applied a time horizon of between 1 and 5 years. The cost-effectiveness results suggest that single-incision mini-sling and mid-urethral slings are among the most cost-effective options.ConclusionsThe review has shown that methods used for the economic evaluation of surgical treatments for SUI vary widely in terms of study design, analysis type, compared alternatives, time horizon, costing methodologies and effect outcomes. Future economic evaluation studies on surgical treatments for SUI may be improved by the application of available guidelines.Systematic review registrationRegistered in PROSPERO in 2016, CRD42016049339.
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Project description:Introduction and hypothesisUrinary incontinence (UI) is defined as any involuntary loss of urine and can be associated with urgency and/or physical exertion. Electrical stimulation (ES) has recently been identified as a proven therapeutic alternative for UI, with few side effects and low cost. This systematic review, registered on the Prospective Register of Systematic Reviews (RD42024528812), investigated whether home-based ES would be as viable as outpatient ES in the treatment of women with UI.MethodsStudy selection was conducted by two independent researchers across the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Web of Science, Scopus, and PEDro (search conducted on February 25, 2024). We also searched the reference lists of eligible articles. There were no restrictions on date and language. The RoB2 and GRADE tools were used to assess methodological quality and evidence recommendation.Results723 articles were found, and four trials were eligible. Very low-quality evidence indicated statistically significant differences in cure rates or improvement of urinary symptoms in women treated with both outpatient and home-based ES. Low-quality evidence recommends home-based ES in maintaining improvement of urinary symptoms, and moderate-quality evidence indicates no severity of symptoms in the home-based group.ConclusionHome-based ES is shown to be as effective as outpatient ES in the treatment of UI in women. However, data analysis revealed low-quality evidence regarding the cure or improvement of the women's conditions.
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Project description:ObjectiveThis study aimed to compare the effectiveness of various conservative treatment strategies for women with stress urinary incontinence.MethodsA comprehensive search of PubMed, Web of Science, Embase, and the Cochrane Library was conducted from their inception through March 2024, without restrictions on language or location. Randomized controlled trials (RCTs) comparing the efficacy of conservative treatments for stress urinary incontinence, using short-term pad test or the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) score as outcome measures, were included. We conducted a network meta-analysis using a random-effects model to compare the effectiveness of different conservative treatment strategies, employing prediction interval plots and league tables, and ranked them according to the surface under the cumulative ranking curve (SUCRA). The quality of the included studies was assessed following the Cochrane Handbook for Systematic Reviews of Interventions.ResultsA total of 31 RCTs involving 1,900 patients across 8 intervention categories were included in the analysis. SUCRA rankings indicated that electrical stimulation (SUCRA = 95.9%) was the most effective therapy for improving ICIQ-UI SF scores, followed by biofeedback electrical stimulation (SUCRA = 84.9%), radiofrequency (SUCRA = 77.5%), biofeedback (SUCRA = 57.8%), magnetic stimulation (SUCRA = 45.3%), pelvic floor muscle training (SUCRA = 38.4%), Er: YAG laser (SUCRA = 37.4%), and CO2 laser (SUCRA = 7.4%). In terms of reducing urine leakage, the treatments were ranked in descending order as follows: Er: YAG laser (SUCRA = 97.5%), biofeedback electrical stimulation (SUCRA = 83.4%), biofeedback (SUCRA = 67.0%), radiofrequency (SUCRA = 59.5%), electrical stimulation (SUCRA = 48.4%), pelvic floor muscle training (SUCRA = 43.0%), magnetic stimulation (SUCRA = 27.8%), and CO2 laser (SUCRA = 21.4%). Based on the clustered rankings of the two metrics, biofeedback electrical stimulation was identified as the most effective therapy for improving stress urinary incontinence.ConclusionBased on the combined analysis of two indicators, we found that biofeedback electrical stimulation may be the optimal therapy for the conservative management of stress urinary incontinence.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024569845.
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Project description:BackgroundStress urinary incontinence (SUI) is a widespread complaint in the adult women. Electroacupuncture has been widely applied in the treatment of SUI. But its efficacy has not been evaluated scientifically and systematically. Therefore, we provide a protocol of systematic evaluation to assess the effectiveness and safety of electroacupuncture treatment on women with SUI.MethodsThe retrieved databases include 3 English literature databases, namely PubMed, Embase, and Cochrane Library, and 3 Chinese literature databases, namely Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), and Wanfang Database. The randomized controlled trials (RCTs) of the electroacupuncture treatment on women with SUI will be searched in the above-mentioned databases from the time when the respective databases were established to December 2017. The change from baseline in the amount of urine leakage measured by the 1-hour pad test will be accepted as the primary outcomes. We will use RevMan V.5.3 software as well to compute the data synthesis carefully when a meta-analysis is allowed.ResultsThis study will provide a high-quality synthesis to assess the effectiveness and safety of electroacupuncture treatment on women with SUI.ConclusionThe conclusion of our systematic review will provide evidence to judge whether electroacupuncture is an effective intervention for women with SUI.Prospero registration numberPROSPERO CRD42017070947.
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Project description:BackgroundUrinary incontinence is a bothersome symptom. Although the relationship between stress urinary incontinence (SUI) and vaginal delivery is established, the pathology underlying SUI after vaginal birth remains to be elucidated.ObjectivesTo determine whether levator ani muscle avulsion predisposes for SUI in women.Search strategyPubmed and Embase were searched for terms and their variations "levator ani muscle avulsion" and "urinary incontinence", from inception until 5 November 2019.Selection criteriaInclusion criterion: studies describing the relationship between urinary incontinence and levator ani muscle avulsion in women at least 1 year after delivery. Exclusion criterion: studies only analyzing the urethral sphincter or hiatus dimensions.Data collection and analysisOdds ratios were used and if not available, were calculated as means of data synthesis, adjusted odds ratios if presented by the study, random-effects model to compute a pooled estimate.ResultsSeven studies were included, accounting for 2388 women. Comparing women with and without levator ani muscle avulsion, the overall odds ratio for SUI is 0.87 (95% confidence interval 0.56-1.34), and after adjustment for possible confounders was 0.72 (95% confidence interval 0.40-1.30).ConclusionThere is no relationship between levator ani muscle avulsion and SUI in women.
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Project description:ObjectiveTo synthesise the evidence for the multifaceted self-management interventions for older women with urinary incontinence (UI) and to understand the outcomes associated with these interventions.DesignA systematic review and narrative synthesis to identify randomised controlled trials that investigated the effect of multifaceted self-management interventions for older women with UI.MethodsMEDLINE, PsycINFO, EMBASE, The Cochrane Library, CINAHL and Applied Social Sciences Index and Abstracts databases were searched (January 1990 to May 2019) using a systematic search strategy, complemented by manually screening the reference lists and citation indexes. Study selection, data extraction and risk of bias assessment were undertaken independently. A narrative synthesis was undertaken in which studies, interventions and outcomes were examined based on the intervention components. The effect size and 95% CI were estimated from each study.ResultsA total of 13 147 citations were identified and 16 studies were included. There was no study rated as of high quality. Three types of multifaceted interventions were found: those that had an element of pelvic floor muscle exercises (PFME), those with bladder retraining and some with combination behavioural interventions. Outcome measures varied across studies. A statistically significant improvement in incontinence symptoms was reported in the intervention group compared with the control in 15 studies.ConclusionMultifaceted interventions that included PFME, bladder retraining or combination behavioural techniques appear to be useful in some settings for UI management in older women, but the quality of the evidence was poor and unclear. There was insufficient evidence to determine whether any of the combination of components is superior to others in improving UI symptoms. There is a need for high-quality studies to confirm the effectiveness of these interventions and to identify comparative effectiveness.Prospero registration numberCRD42018104010.
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Project description:BackgroundThere is no pooled evidence regarding the prevalence and potential factors associated with depression among women with urinary incontinence worldwide. Hence, a systematic review and meta-analysis were conducted to determine the overall prevalence of depression among urinary incontinent women globally and explore any heterogeneity present.MethodsA computerized systematic literature search was performed using the Scopus, PubMed, Embase, Google Scholar, and Snowballing databases. Each database was searched from its start date of March 20, 2023. The study conforms to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. All included articles were published in English and evaluated the prevalence and associated factors of depression among urinary incontinent female patients. Pooled estimations with a 95% confidence interval (CI) were calculated with the DerSimonian‒Laird (DL) random-effects model. Publication bias was evaluated by using funnel plots and statistical tests.ResultsOur initial electronic database search with the chosen search terms identified 1120 articles in PubMed (35 4), Embase (105), Scopus (325) and Google Scholar (176). The results of the 8 studies reporting a binary outcome using the different validation scales are summarized in the overall prevalence of depression was 18% (95% CI = 11-25%). Unable to read and write (OR: 1.34, 95% CI: [1.01, 1.78], I²= 0%), caesarean delivery (OR: 1.48, 95% CI: [1.30, 1.70], I² = 0%), obesity (OR: 1.37, 95% CI: [1.19, 1.58], I² = 0%), party greater than three (OR: 1.26, 95% CI: [0.98, 1.62], I²= 0%), comorbidity (OR: 1.32, 95% CI: [1.16, 1.49], I² = 85.3%), smoking (OR: 1.58, 95% CI: [0.99, 1.92], I2 = 0%) and single, divorced and widowed (OR: 1.67, 95% CI: [1.45, 1.92], I² = 0%) were the major factors associated with depression.Conclusion and recommendationsThis review demonstrated the high prevalence of depression among women with urinary incontinence. Being unable to read and write, delivery via caesarean section, obesity, having more than three children, having comorbidities, smoking, being single, being divorced and being widowed were all associated factors. This study identified that there was a strong association between urinary incontinence and depression. Future studies recommend focusing on the causal association between depression and urinary incontinence.ProsperoRegistration numbers of CRD42023418779.
| S-EPMC11539296 | biostudies-literature
Project description:BackgroundPostpartum stress urinary incontinence significantly impacts the quality of life and the physical and mental health of women. A reliable predictive model for postpartum stress urinary incontinence can serve as a preventive tool. Currently, there have been numerous studies developing predictive models to assess the risk of postpartum stress urinary incontinence, but the quality and clinical applicability of these models remain unknown.ObjectiveTo systematically review and evaluate existing models for predicting stressful postpartum risks.MethodsPubMed, EBSCO, The Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, WanFang Data, SinoMed, and VIP Data databases were systematically searched from the time of database construction to October 2023. Two researchers used Critical appraisal and data extraction for systematic reviews of prediction modeling studies: the CHARMS checklist for data extraction. Three researchers used The Prediction Model Risk of Bias Assessment Tool (PROBAST) checklist for bias and applicability assessment.ResultsEight papers including ten postpartum stress urinary incontinence prediction models were finalized. The most common predictors in the prediction models were urinary incontinence (UI) during pregnancy, followed by mode of delivery, Maternal age, parity, and UI before pregnancy. Nine of the prediction models reported discrimination with an area under the ROC curve (AUC) or C-index between 0.680 and 0.850. All included studies were at high risk of bias, mainly due to mishandling of continuous predictors, unreported or mishandled missing data, and inadequate assessment of predictive model performance.ConclusionsPostpartum stress urinary incontinence risk prediction models are in the initial development stage, and existing prediction models have a high risk of bias and poor modeling methodological quality, which may hinder their clinical application. In the future, healthcare practitioners should follow the norms of predictive model development and reporting to develop risk prediction models with superior predictive performance, low risk of bias, and easy clinical application.
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