Efficacy of magnetic stimulation for female stress urinary incontinence: a meta-analysis

Abstract

Aim: This meta-analysis aimed to evaluate the efficacy of magnetic stimulation (MS) in treating female stress urinary incontinence (SUI) and providing an alternative treatment for patients who are unwilling to undergo surgery. Methods: Randomized controlled trials (RCTs) that evaluated MS as a remedy for female SUI were retrieved from various electronic databases, including MEDLINE, EMBASE, and the Cochrane Controlled Trial Registry system. Moreover, reference lists for related papers were carefully screened for relevant studies. Results: A total of six RCTs evaluating the effect of MS in treating female SUI were included in this study. Compared with the placebo group, the MS group exhibited higher quality-of-life scores [mean difference (MD) 0.59, 95% credibility interval (CI) 0.23–0.95; p = 0.001] and lower International Consultation on Incontinence Questionnaire scores (MD −3.93, 95% CI −5.85 to −2.01; p < 0.0001). Moreover, they exhibited a higher objective cure rate (odds ratio 8.49, 95% CI 3.08–23.37). In addition, MS treatment reduced the number of episodes of urinary incontinence (MD −1.42, 95% CI −2.24 to −0.59; p = 0.0007) and urine loss on pad test (MD −4.67, 95% CI −8.05 to −1.28; p = 0.007). There were no significant treatment-related adverse reactions. Conclusion: This study evaluated the efficacy and safety of MS in the treatment of female SUI. The results have important implications for patients who do not wish to undergo surgical therapy. We found that MS treatment for SUI has positive outcomes, however, future studies should aim at establishing the best protocol for optimizing the therapeutic effect.

Updates to Surgical Treatment of Female Stress Urinary Incontinence (SUI): AUA/SUFU Guideline (2023)

“…39,40 Similarly, despite limitations to the data that include significant heterogeneity in the data and stimulation protocols, all meta-analyses comparing magnetic stimulation to sham or placebo concluded that magnetic stimulation appears to be safe and may be effective in reducing SUI. [41][42][43] A Cochrane review 44 of 3,781 patients in 51 studies comparing non-implanted electrical stimulation (ES) to various other interventions (PFME, vaginal cones, sham) or no intervention provided the most robust evidence on ES. While the review indicated that ES is more effective than sham or no active treatment, it was not possible to say whether or not ES has similar efficacy to PFME or other active treatments.…”

“…39,40 Similarly, despite limitations to the data that include significant heterogeneity in the data and stimulation protocols, all meta-analyses comparing magnetic stimulation to sham or placebo concluded that magnetic stimulation appears to be safe and may be effective in reducing SUI. 41-43…”

Flat Magnetic Stimulation for Stress Urinary Incontinence: A Prospective Comparison Study

“…MS is a non-invasive therapeutic device that interacts with the neuromuscular tissue through a specific electromagnetic field, inducing intense contractions (involuntary and otherwise unachievable regular gym training or superficial electrical stimulation) that stimulate pelvic floor muscles deep down and restoring neuromuscular control. Various clinical trials have evaluated the efficacy of MS in ameliorating female SUI with positive outcomes [ 27 ]. However, due to heterogeneous results and weak evidence of the short-term and long-term effects, current European Urology Association recommendations advise against treating urinary with magnetic stimulation [ 28 ].…”

Pelvic Floor Muscle Training versus Functional Magnetic Stimulation for Stress Urinary Incontinence in Women: A Randomized Controlled Trial

“…Fitz et al [20] and Felicíssimo et al [21] reported equal benefits of supervised (outpatient) and unsupervised (home programs) PFMT for improving female SUI, and this may be considered an option for self-management strategy [22]. Specific PFMT exercises, called Kegels, are proven to be effective for female UI and pelvic organ prolapse and have been recommended as the initial therapeutic option [23], but the training needs proper instructions and close follow-up to be effective [24].…”

“…There have been many articles published in 5 recent years [17,23,26,28,29,31] discussing the benefits of using FMS in the management of UI. Peng et al [34] state that "magnetic stimulation leads to an improvement in SUI without any reported safety concerns and an improvement in patient quality of life", but the authors agree on the uncertainty of the long-term effect of this technique.…”