Table 3.
Clinical Intervention on Urinary Incontinence (Results From Individual RCTs)
| Author, Year (Follow-up in Months) | Active | Control | Outcomes | Events/Active | Events/Control | Absolute Risk Difference (95% CI) (Top) Relative Risk (95% CI) (Bottom) |
| Wille, 2003134 (12) | Postoperative PFMT | Postoperative, electrical stimulation | Continence | 41/47 | 41/46 | −0.02 (−0.15–0.11) |
| 0.98 (0.84–1.14) | ||||||
| Yokoyama, 2004135 (6) | Extracorporeal magnetic innervation | PFMT | Continence | 11/12 | 10/12 | 0.08 (−0.18–0.35) |
| 1.1 (0.81–1.5) | ||||||
| Porru, 2001138 (1) | PFMT | Standard care | UI | 4/30 | 12/28 | −0.30 (−0.52–−0.08)* |
| 0.31 (0.11–0.85)* | ||||||
| Dorey, 2004139 (3) | PFMT | Advice on lifestyle changes | Improved UI | 14/28 | 1/27 | 0.46 (0.26–0.66)* |
| 13.5 (1.90–95.71)* | ||||||
| Moore, 1999173 (6) | Intensive PFMT conducted by a physiotherapist | Standard treatment | UI that affected life | 6/19 | 3/21 | 0.17 (−0.08–0.43) |
| 2.21 (0.64–7.63) | ||||||
| Burgio, 2006174 (6) | Preoperative session of biofeedback-assisted PFMT | Usual care | Need protection | 16/63 | 24/62 | −0.13 (−0.30–0.03) |
| 0.66 (0.39–1.11) | ||||||
| UI | 11/63 | 24/62 | −0.21 (−0.37–−0.06)* | |||
| 0.45 (0.24–0.84)* | ||||||
| UI that affected life | 28/63 | 33/62 | −0.09 (−0.26–0.09) | |||
| 0.84 (0.58–1.20) | ||||||
| Chancellor, 1999140 (24) | UroLume sphincteric stent prosthesis | Conventional external sphincterotomy | Improved UI | 12/31 | 6/26 | 0.16 (−0.08–0.39) |
| 1.68 (0.73–3.85) | ||||||
| Deliveliotis, 2005155 (12) | Neurovascular bundles with steroid cream applied locally to both neurovascular bundles | Usual neurovascular bundles | Continence | 28/30 | 27/30 | 0.03 (−0.11–0.17) |
| 1.04 (0.90–1.21) | ||||||
| Parsons, 2004156 (12) | Methylprednisolone beginning on postoperative day intravenously, then orally | Placebo | Continence | 33/34 | 36/36 | −0.03 (−0.11–0.05) |
| 0.97 (0.90–1.05) | ||||||
| Little, 2003148 (24) | Radiation with a 4-field box technique to a dose of 70 Gy | Radiation with 6-field boost plan of a total dose of 78 Gy | UI | 40/108 | 32/103 | 0.06 (−0.07–0.19) |
| 1.19 (0.82–1.75) | ||||||
| Need protection | 4/108 | 5/103 | −0.01 (−0.07–0.04) | |||
| 0.76 (0.21–2.76) | ||||||
| Wasson, 1995152 (36) | Transurethral resection of prostate | Watchful waiting | Persistent UI | 4/280 | 4/276 | 0.00 (−0.02–0.02) |
| 0.99 (0.25–3.90) | ||||||
| Srougi, 2005150 (6) | Retropubic radical prostatectomy with bladder neck mucosal eversion | Retropubic radical prostatectomy | UI | 44/48 | 43/47 | 0.00 (−0.11–0.11) |
| 1.00 (0.88–1.13) | ||||||
| Van Cangh, 1998153 (24) | 60 Gy external radiotherapy between 12 and 16 wk after radical prostatectomy | Radical prostatectomy alone | Continence | 37/48 | 43/52 | −0.06 (−0.21–0.10) |
| 0.93 (0.76–1.17) | ||||||
| UI | 0/48 | 0/52 | 0 | |||
| Severe UI with implantation of artificial sphincter | 1/48 | 1/52 | 0.00 (−0.05–0.06) | |||
| 1.08 (0.07–16.84) | ||||||
| Srougi, 2001144 (6) | Radical retropubic prostatectomy with bladder neck preservation (Malizia) | Radical retropubic prostatectomy with bladder neck resection (Walsh) | Continence | 30/31 | 36/39 | 0.04 (−0.06–0.15) |
| 1.05 (0.94–1.17) | ||||||
| Ghaly, 2003147 (12) | Radiotherapy with I-125 (144 Gy, TG-43) | Radiotherapy with Pd-103 | Need protection or self-catheterization | 1/57 | 5/51 | −0.08 (−0.17–0.01) |
| 0.18 (0.02–1.48) | ||||||
| Radiotherapy with Pd-103 (90 Gy) | Radiotherapy with Pd-103 (115 Gy) | Need protection or self-catheterization | 3/57 | 5/51 | −0.05 (−0.15–0.05) | |
| 0.54 (0.14–2.14) | ||||||
| Imamoglu, 2005149 (48) | Macroplastique injection | Artificial urethral sphincter implantation | Continence | 8/10 | 10/11 | −0.11 (−0.41–0.19) |
| 0.88 (0.61–1.26) | ||||||
| UI | 1/10 | 0/11 | 0.10 (−0.13–0.33) | |||
| 3.27 (0.15–72.23) | ||||||
| Improved UI | 3/13 | 8/11 | −0.50 (−0.85–−0.15)* | |||
| 0.32 (0.11–0.91)* | ||||||
| Akakura, 1999143 (58) | Radical prostatectomy with androgen antagonist | External beam radiation with androgen antagonist | Improved UI | 22/56 | 0/44 | 0.39 (0.26–0.52)* |
| 35.53 (2.22–569.82)* | ||||||
| Fransson, 2001145 (35) | Radiotherapy with a total dose of 4.8 Gy | Active surveillance | Need protection | 10/59 | 1/49 | 0.15 (0.05–0.25)* |
| 8.31 (1.10–62.63)* | ||||||
| Gupta, 2002146 (12) | Transurethral resection of the prostate with the thick vapor resection loop | Transurethral resection of the prostate with standard wire loop | UI | 0/50 | 2/50 | −0.04 (−0.11–0.03) |
| 0.2 (0.01–4.06) | ||||||
| Gallucci, 1998154 (12) | Transurethral resection of the prostate | Transurethral electrovaporization of the prostate | UI | 0/80 | 13/70 | −0.19 (−0.28–−0.09)* |
| 0.03 (0.00–0.54)* | ||||||
| Wilson, 2006151 (12) | Holmium laser enucleation of the prostate | Transurethral resection of the prostate | Regained UI | 15/30 | 8/30 | 0.23 (−0.01–0.47) |
| 1.88 (0.94–3.75) | ||||||
| UI | 1/30 | 0/30 | 0.03 (−0.05–0.12) | |||
| 3 (0.13–70.83) | ||||||
| Steineck, 2002142 (12) | Radical prostatectomy | Watchful waiting | Frequent UI | 80/189 | 33/187 | 0.25 (0.16–0.34)* |
| 2.40 (1.69–3.41)* | ||||||
| UI | 101/189 | 53/187 | 0.25 (0.15–0.35)* | |||
| 1.89 (1.45−2.45)* | ||||||
| Moderate or severe UI | 30/189 | 3/187 | 0.14 (0.09–0.20)* | |||
| 9.89 (3.07–31.86)* | ||||||
| Moderate or great distress from UI | 47/189 | 15/187 | 0.17 (0.10–0.24)* | |||
| 3.10 (1.80–5.35)* | ||||||
| Great distress | 14/189 | 5/187 | 0.05 (0.00–0.09)* | |||
| 2.77 (1.02–7.54)* | ||||||
| Regular need protection | 71/189 | 16/187 | 0.29 (0.21–0.37)* | |||
| 4.39 (2.65–7.26)* | ||||||
| Regular dependence on diaper or urine bag | 23/189 | 1/187 | 0.12 (0.07–0.16)* | |||
| 22.76 (3.10–166.80)* | ||||||
| UI affecting sexual life | 15/189 | 5/187 | 0.05 (0.01–0.10)* | |||
| 2.97 (1.10–8.00)* |
RCT, randomized controlled trial; PFMT, pelvic floor muscle training; UI, urinary incontinence.
*
Significant association at 95% confidence level.