Effect of vaginal energy-based treatment on female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials

Purpose To evaluate the efficacy and safety of vaginal energy-based therapies in treating female SUI. Methods The PubMed, EMBASE, Web of Science, and Scopus databases were searched up to September 2022 to identify RCTs comparing energy-based therapies with placebo intervention in treating female SUI...

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Published in:World journal of urology 2023-02, Vol.41 (2), p.405-411
Main Authors: Zhang, Chi, Chen, Yuanzhuo, Liu, Shengzhuo, Chen, Jiawei, Shen, Hong, Luo, Deyi
Format: Article
Language:English
Subjects:
Carbon dioxide
Clinical trials
CRD
CRD42022360471
Energy
Female
Humans
Medicine
Medicine & Public Health
Meta-analysis
Nephrology
Oncology
Original Article
Placebos
Randomized Controlled Trials as Topic
Treatment Outcome
Urinary Incontinence
Urinary Incontinence, Stress - therapy
Urology
Vagina
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Summary:Purpose To evaluate the efficacy and safety of vaginal energy-based therapies in treating female SUI. Methods The PubMed, EMBASE, Web of Science, and Scopus databases were searched up to September 2022 to identify RCTs comparing energy-based therapies with placebo intervention in treating female SUI. The primary outcome was International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score. Secondary outcomes included the 1-h pad test and cure rate. Results A total of 577 patients from 6 studies were included in the meta-analysis. Energy-based therapies did not significantly improve the ICIQ-SF score at all visits (≤ 1 month: SMD, -0.39; 95% CI − 0.80 to 0.03; P  = 0.07; 3 months: SMD, − 1.32; 95% CI − 4.07 to 1.43; P  = 0.35; 6 months: SMD, − 0.39; 95% CI − 0.91 to 0.12; P  = 0.14). The subgroup analysis showed that there was no significant improvement in ICIQ-SF score in the CO 2 laser group compared to the placebo group at all visits (≤ 1 month: SMD, − 0.13; 95% CI − 0.59 to 0.34; P  = 0.59; 3 months: SMD, − 1.50; 95% CI − 3.91 to 0.92; P  = 0.22; 6 months: SMD, 0.13; 95% CI − 0.47 to 0.72; P  = 0.67). Meta-analysis was not performed in Er: YAG laser and radiofrequency therapy due to insufficient trials. Conclusion Based on the limited clinical evidence, our meta-analysis showed no prior efficacy of energy-based therapy over placebo intervention. However, the results of this meta-analysis should be taken with caution due to the limited amount of available evidence and the heterogeneity among the included studies. PROSPERO registration number CRD42022360471.
ISSN:1433-8726
0724-4983
1433-8726
DOI:10.1007/s00345-022-04247-1