Académique Documents
Professionnel Documents
Culture Documents
Objectives: This systematic review and metaanalysis compared the effects of biofeedbackassisted
pelvic floor muscle training with those of pelvic floor muscle training alone in
patients with urinary incontinence after radical prostetactomy.
Design: A review and metaanalysis study design.
Data sources: The metaanalysis was conducted in accordance with the Preferred Reporting
Items for Systematic Reviews and MetaAnalyses guidelines. A systematic search of
PubMed/Medline OVID, the Cumulative Index to Nursing and Allied Health Literature,
Cochrane Library, BioMedCentral, Web of Science, Chinese Electronic Periodical Services,
Chinese Journal and Thesis Database, and China National Knowledge Infrastructure was
performed for retrieving records.
Tujuan: Ini review sistematis dan meta-analisis membandingkan efek dari
pelatihan otot dasar panggul biofeedbackassisted dengan orang-orang dari
pelatihan otot dasar panggul sendirian di
pasien dengan inkontinensia urin setelah prostetactomy radikal.
Desain: Sebuah tinjauan dan metaanalisis desain studi.
Sumber data: metaanalisis ini dilakukan sesuai dengan Pelaporan Preferred
Item untuk sistematis Ulasan dan pedoman MetaAnalyses. Sebuah pencarian
sistematis
PubMed / Medline OVID, Indeks Kumulatif untuk Keperawatan dan Sekutu
Kesehatan Sastra,
Cochrane Library, BioMedCentral, Web of Science, Cina Elektronik Periodical
Services,
Cina Journal dan Skripsi Database, dan China Knowledge Nasional Infrastruktur
adalah
dilakukan untuk mengambil catatan.
Review methods: For determining the effects of training type on urinary incontinence,
randomized controlled trials on biofeedback-assisted pelvic floor muscle training with or
without electrical stimulation were compared with those on pelvic floor muscle training
with or without electrical stimulation, respectively, in the metaanalysis. The Cochrane
Collaboration tool in the Cochrane Handbook for Systematic Review of Interventions
5.1.0 was used to assess the methodological quality of the included trials. Subjective and
objective measurement of urinary incontinence improvement and the quality of life were
the primary and secondary outcome measures, respectively. Data were analyzed using
Comprehensive Meta-Analysis software 2.0. In addition, subgroup analyses and
metaregression were performed to explore the possible sources of heterogeneity.
Results: Thirteen randomized controlled trials involving 1108 patients with prostatectomy
incontinence were included. The immediate-, intermediate-, and long-term effects
of objectively measured biofeedback-assisted pelvic floor muscle training on urinary
incontinence were significant (mean effect size = 0.316, 0.335, and 0.294; 95% CI:
0.589 to 0.043, 0.552 to 0.118 and 0.535 to 0.053; p = 0.023, 0.002, and 0.017,
respectively) when compared with those of pelvic floor muscle training alone. However,
when urinary incontinence was measured subjectively, only the intermediate and longterm effects
of biofeedback were found (p = 0.034 and 0.005, respectively). Small-tomoderate immediate- and
intermediate-term effects on the quality of life were observed
Review methods: For determining the effects of training type on urinary incontinence,
randomized controlled trials on biofeedback-assisted pelvic floor muscle training with or
without electrical stimulation were compared with those on pelvic floor muscle training
with or without electrical stimulation, respectively, in the metaanalysis. The Cochrane
Collaboration tool in the Cochrane Handbook for Systematic Review of Interventions
5.1.0 was used to assess the methodological quality of the included trials. Subjective and
objective measurement of urinary incontinence improvement and the quality of life were
the primary and secondary outcome measures, respectively. Data were analyzed using
Comprehensive Meta-Analysis software 2.0. In addition, subgroup analyses and
metaregression were performed to explore the possible sources of heterogeneity.
Results: Thirteen randomized controlled trials involving 1108 patients with prostatectomy
incontinence were included. The immediate-, intermediate-, and long-term effects
of objectively measured biofeedback-assisted pelvic floor muscle training on urinary
incontinence were significant (mean effect size = 0.316, 0.335, and 0.294; 95% CI:
0.589 to 0.043, 0.552 to 0.118 and 0.535 to 0.053; p = 0.023, 0.002, and 0.017,
respectively) when compared with those of pelvic floor muscle training alone. However,
when urinary incontinence was measured subjectively, only the intermediate and longterm effects
of biofeedback were found (p = 0.034 and 0.005, respectively). Small-tomoderate immediate- and
intermediate-term effects on the quality of life were observed
metode Ulasan: Untuk menentukan efek dari jenis pelatihan inkontinensia urin,
uji coba terkontrol secara acak pada pelatihan otot dasar panggul biofeedback
yang dibantu dengan atau
tanpa stimulasi listrik dibandingkan dengan mereka pada pelatihan otot dasar
panggul
dengan atau tanpa stimulasi listrik, masing-masing, di metaanalisis tersebut.
The Cochrane
alat kolaborasi di Cochrane Buku Pegangan untuk Systematic Review dari
Intervensi
5.1.0 digunakan untuk menilai kualitas metodologi percobaan termasuk.
subjektif dan
pengukuran tujuan perbaikan inkontinensia urin dan kualitas hidup yang
langkah-langkah hasil primer dan sekunder, masing-masing. Data dianalisis
dengan menggunakan
Komprehensif Meta-Analisis software 2.0. Selain itu, analisis subkelompok dan
metaregression dilakukan untuk mengeksplorasi sumber heterogenitas.
Hasil: Tiga belas uji coba terkontrol secara acak yang melibatkan 1.108
pasien dengan prostatektomi inkontinensia dimasukkan. Efek jangka panjang
immediate-, intermediate-, dan
dari diukur secara obyektif dasar panggul pelatihan otot biofeedback-dibantu
pada kemih
inkontinensia yang signifikan (berarti efek ukuran = 0,316, 0,335, dan 0,294;
95% CI:
0,589-0,043, 0,552-0,118 dan 0,535-0,053; p = 0,023, 0,002, dan 0,017,
masing-masing) bila dibandingkan dengan orang-orang dari pelatihan otot dasar
panggul sendiri. Namun,
ketika inkontinensia urin diukur secara subyektif, hanya efek menengah dan
jangka panjang dari biofeedback ditemukan (p = 0,034 dan 0,005, masing-
masing). Kecil-tomoderate immediate- dan jangka menengah efek pada kualitas
hidup yang diamati
What is already known about the topic?
Urinary incontinence is a common symptom observed
after surgery in patients with prostate cancer.
Urinary incontinence constitutes a considerable burden
to the families and caregivers of patients after prostatectomy and negatively affects the quality
of life.
Pelvic floor muscle training is the first line treatment
used to increase the strength and endurance of pelvic
floor muscles.
What this paper adds
This review shows that biofeedback provides additional
benefits for men with urinary incontinence compared
with pelvic floor muscle training alone.
Urinary incontinence measured objectively supported the
immediate benefits of biofeedback on urinary incontinence, whereas subjective measurements
revealed otherwise.
The quality of the methodology and qualifications of
biofeedback therapists might be key factors explaining
the apparent lack of immediate treatment effects in the
current metaanalysis
Apa yang sudah diketahui tentang topik?
Inkontinensia urin merupakan gejala umum diamati
setelah operasi pada pasien dengan kanker prostat.
Inkontinensia urin merupakan beban yang cukup
kepada keluarga dan pengasuh pasien setelah prostatektomi dan negatif
mempengaruhi kualitas hidup.
pelatihan otot dasar panggul adalah pengobatan lini pertama
digunakan untuk meningkatkan kekuatan dan daya tahan panggul
otot dasar.
Apa makalah ini menambahkan
Ulasan ini menunjukkan bahwa biofeedback memberikan tambahan
manfaat untuk pria dengan inkontinensia urin dibandingkan
dengan pelatihan otot dasar panggul sendiri.
Inkontinensia urin diukur secara obyektif mendukung
manfaat langsung dari biofeedback pada inkontinensia urin, sedangkan
pengukuran subjektif mengungkapkan sebaliknya.
Kualitas metodologi dan kualifikasi
terapis biofeedback mungkin faktor kunci yang menjelaskan
jelas kurangnya efek pengobatan segera di
metaanalisis saat
1. Introduction
Urinary incontinence is common in patients who have
undergone radical prostatectomy, with a prevalence in
men ranging from 2% to nearly 60%, depending on the
populations and sites studied, the definitions used, and the
timing of assessment of continence after surgery (Milsom
et al., 2009). Furthermore, urinary incontinence may
restrict patients’ physical activities and negatively affect
their activities of daily living and health-related quality of
life (Kirschner-Hermanns and Jakse, 2002). The literature
shows that a misunderstanding of urinary incontinence
management might affect urinary incontinence care; thus,
families and caregivers must exert considerable long-term
care efforts for patients with urinary incontinence (Jansen
et al., 2013). Families and caregivers might have negative
emotions toward patients with urinary incontinence or
even themselves because urinary incontinence-related
accidents cannot be predicted or prevented (Garcia et al.,
2005).
Although the mechanisms of postprostatectomy incontinence remain unclear, sphincter
insufficiency and
detrusor over-activity are considered the main causes
(Hoyland et al., 2014; Kielb and Clemens, 2005). Pelvic
floor muscle training is the first-line treatment for
1. Perkenalan
Inkontinensia urin adalah umum pada pasien yang memiliki
mengalami prostatektomi radikal, dengan prevalensi di
laki-laki mulai dari 2% menjadi hampir 60%, tergantung pada
populasi dan situs belajar, definisi yang digunakan, dan
waktu penilaian kontinensia setelah operasi (Milsom
et al., 2009). Selanjutnya, inkontinensia urin mungkin
membatasi kegiatan fisik pasien dan mempengaruhi secara negatif
kegiatan mereka sehari-hari dan kualitas kesehatan yang berhubungan
hidup (Kirschner-Hermanns dan Jakse, 2002). Literatur
menunjukkan bahwa kesalahpahaman inkontinensia urin
manajemen dapat mempengaruhi perawatan inkontinensia urin; demikian,
keluarga dan pengasuh harus mengerahkan jangka panjang yang cukup besar
merawat upaya untuk pasien dengan inkontinensia urin (Jansen
et al., 2013). Keluarga dan pengasuh mungkin negatif
emosi terhadap pasien dengan inkontinensia urin atau
bahkan diri mereka sendiri karena kemih inkontinensia terkait
kecelakaan tidak dapat diprediksi atau dicegah (Garcia et al.,
2005).
Meskipun mekanisme postprostatectomy inkontinensia tetap tidak jelas,
sfingter insufisiensi dan
detrusor over-aktivitas yang dianggap penyebab utama
(Hoyland et al, 2014;. Kielb dan Clemens, 2005). panggul
pelatihan otot dasar adalah pengobatan lini pertama untuk
3. Results
3.1. Record retrieval results
We retrieved 107 potential relevant records from
9 databases, and 36 duplicates were excluded. Of the
remaining 71 records, 44 were found to be ineligible for
study inclusion after reviewing the titles and abstracts. Of
the excluded studies, two studies were abstracts in
conference proceedings, 24 studies were review articles,
nine studies did not assess the effect of biofeedbackassisted pelvic floor muscle training or
assess the
combination effects of biofeedback with other intervention
without using that intervention as a control group (i.e.,
biofeedback with supporting group versus usual care, etc.),
three studies did not use pelvic floor muscle training as a
control group for comparison, and six studies included
participants other than patients with prostate cancer after
prostatectomy (i.e., patients were receiving transurethral
resection of the prostate, with multiple sclerosis, or with
benign prostatic hypertrophy). Two additional studies
were discarded because the papers were not written in
English (i.e., Italian and German). The full text of the
remaining 25 records were retrieved and reviewed. Among
them, 12 studies did not meet the inclusion criteria. Two
studies were excluded because they were not randomized
controlled trials, two were excluded because they assessed
the combination effects of biofeedback-assisted pelvic
floor muscle training and electrical stimulation without
using electrical stimulation as a control group, two were
excluded because they did not use pelvic floor muscle
training as an active control group for comparison, four
studies were excluded because there is no comparison
3. Hasil
3.1. Hasil rekaman pengambilan
Kami diambil 107 calon catatan yang relevan dari
9 database, dan 36 duplikat dikeluarkan. Dari
tersisa 71 catatan, 44 ditemukan tidak memenuhi syarat untuk
belajar inklusi setelah meninjau judul dan abstrak. Dari
studi dikecualikan, dua studi yang abstrak di
prosiding konferensi, 24 studi yang ulasan artikel,
sembilan studi tidak menilai efek dari pelatihan otot dasar panggul
biofeedbackassisted atau menilai
efek kombinasi dari biofeedback dengan intervensi lain
tanpa menggunakan intervensi yang sebagai kelompok kontrol (yaitu,
biofeedback dengan mendukung kelompok perawatan biasa dibandingkan, dll),
tiga studi tidak menggunakan pelatihan otot dasar panggul sebagai
kelompok kontrol untuk perbandingan, dan enam studi termasuk
peserta selain pasien dengan kanker prostat setelah
prostatektomi (yaitu, pasien menerima transurethral
reseksi prostat, dengan multiple sclerosis, atau dengan
benign prostatic hypertrophy). Dua studi tambahan
dibuang karena surat-surat itu tidak ditulis di
English (yaitu, Italia dan Jerman). Teks lengkap dari
Sisa 25 catatan yang diambil dan Ulasan. Antara
mereka, 12 studi tidak memenuhi kriteria inklusi. Dua
Studi dikeluarkan karena mereka tidak acak
uji coba terkontrol, dua dikeluarkan karena mereka dinilai
efek kombinasi panggul biofeedback yang dibantu
pelatihan otot dasar dan stimulasi listrik tanpa
menggunakan stimulasi listrik sebagai kelompok kontrol, dua
dikecualikan karena mereka tidak menggunakan otot dasar panggul
pelatihan sebagai kelompok kontrol aktif untuk perbandingan, empat
Studi dikeluarkan karena tidak ada perbandingan
4. Discussion
This metaanalysis included 13 randomized controlled
trials that compared biofeedback-assisted pelvic floor
muscle training with pelvic floor muscle training alone.
Overall, the evidence revealed that biofeedback-assisted
pelvic floor muscle training exerts immediate-, intermediate-, and long-term beneficial effects on
urinary
incontinence compared with pelvic floor muscle training
alone when urinary incontinence was measured objectively (i.e., pad weight). However, when
urinary incontinence was measured subjectively (i.e., urinary
incontinence episodes, the number of pads used, and
self-reported urinary incontinence severity), only intermediate- and long-term beneficial effects
were observed
on urinary incontinence.
4. Diskusi
metaanalisis ini termasuk 13 acak terkontrol
percobaan yang membandingkan biofeedback yang dibantu dasar panggul
pelatihan otot dengan latihan otot dasar panggul sendiri.
Secara keseluruhan, bukti menunjukkan bahwa biofeedback yang dibantu
pelatihan otot dasar panggul diberikannya immediate-, intermediate-, dan
jangka panjang efek menguntungkan pada urin
inkontinensia dibandingkan dengan pelatihan otot dasar panggul
sendirian ketika inkontinensia urin diukur secara objektif (yaitu, pad berat
badan). Namun, ketika inkontinensia urin diukur secara subyektif (yaitu, urin
episode inkontinensia, jumlah bantalan yang digunakan, dan
dilaporkan sendiri kemih inkontinensia keparahan), hanya intermediate- dan
efek menguntungkan jangka panjang yang diamati
pada inkontinensia urin.
5. Conclusion
Based on the available evidence, this metaanalysis
suggests that biofeedback-assisted pelvic floor muscle
training exerts beneficial effects on improving urinary
incontinence in men who have undergone radical prostatectomy.
Author contributions: Pei-Shan Tsai had full access to all the
data in the study and assumes responsibility for the integrity
of the data and the accuracy of the data analysis. P.S. Tsai and
L.H. Hsu developed the concept and contributed to the study
design, data analysis, data interpretation, revisions, and manuscript preparation. Y.M. Liao and
F.C. Lai contributed to
critical revision of the manuscript for important intellectual
content.
Conflict of interest: The authors declare no potential conflicts
of interest regarding the authorship or publication of this
paper.
Funding: None
5. Kesimpulan
Berdasarkan bukti yang ada, metaanalisis ini
menunjukkan bahwa otot dasar panggul biofeedback yang dibantu
pelatihan diberikannya efek menguntungkan pada peningkatan kemih
inkontinensia pada pria yang telah menjalani prostatektomi radikal.
Author kontribusi: Pei-Shan Tsai memiliki akses penuh ke semua
Data dalam penelitian dan bertanggung jawab untuk integritas
dari data dan akurasi analisis data. PS Tsai dan
L.H. Hsu mengembangkan konsep dan kontribusi untuk penelitian
desain, analisis data, interpretasi data, revisi, dan persiapan naskah. Y.M.
Liao dan F.C. Lai berkontribusi
revisi kritis naskah untuk intelektual penting
konten.
Konflik kepentingan: Para penulis menyatakan tidak ada potensi konflik
menarik mengenai penulis atau publikasi ini
kertas.
Pendanaan: Tidak ada