Efficacy of pelvic floor muscle exercise or therapy with or without duloxetine: a systematic review and network Meta-analysis

Park, Jae Joon; Kwon, Allison; Noh, Tae Il; Gwon, Yong Nam; Shim, Sung Ryul; Kim, Jae Heon

doi:10.1080/13685538.2022.2069238

Cited by 5 publications

(15 citation statements)

References 37 publications

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“…21,25,27,29,31 The majority of studies used two-person replicate data extraction, except for five studies. 18,24,27,31,36 Only one study provided a list of literature exclusions with reasons, 31 another study only provided an exclusionary list, 26 and the rest did not. Eleven studies used appropriate tools to assess the risk of bias for each included study.…”

Section: Methodological Qualitymentioning

confidence: 99%

“…Eleven studies used appropriate tools to assess the risk of bias for each included study. 20,22,24,25,27,29,30,[34][35][36][37] One study did not use appropriate statistical methods for data combination because it still used a fixed-effects model when heterogeneity was large. 24 Only five studies discussed their results without considering the possible impact of the risk of bias in the included studies.…”

Section: Methodological Qualitymentioning

confidence: 99%

“…Therefore, we eventually included 18 systematic reviews and meta-analyses in this article (Figure 1). [18][19][20][21][22][23][24][25][26][27][28][29][30][31][34][35][36][37]…”

Section: Study Selectionmentioning

confidence: 99%

“…Of the 18 studies, three were systematic reviews, 27,28,31 five were meta-analyses, 22,23,29,30,34 and the remaining 10 were systematic reviews and meta-analyses. [18][19][20][21][24][25][26][35][36][37] The original study types included in one study were prospective and retrospective studies, 24 one study included randomized controlled trials (RCTs) and retrospective studies, 19 one study included RCTs and prospective trials, 37 and the rest included only RCTs. Ten studies assessed the risk of bias of the included primary studies using the Cochrane Collaboration's Risk of Bias Tool, 20,22,24,25,29,30,[34][35][36][37] and one study 27 assessed the quality of concealment of treatment allocation for randomization based on the scale developed by Schulz et al 40 Four studies assessed the quality of evidence using the Physiotherapy Evidence Database (PEDro), 21,23,28,31 two studies used the Oxford Centre for Evidence-Based Medicine (OCEBM), 18,19 and one study used GRADE.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Effect of pelvic floor muscle training on urinary incontinence after radical prostatectomy: An umbrella review of meta-analysis and systematic review

Yang

et al. 2022

Clin Rehabil

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Objective To analyse the specific exercise effects of pelvic floor muscle training (PFMT) with or without biofeedback or electrical stimulation on urinary incontinence rehabilitation after radical prostatectomy. Data sources We searched PubMed, Embase, Cochrane Database of Systematic Reviews, Web of Science and Scopus databases for systematic reviews and meta-analyses on PFMT for urinary incontinence after radical prostatectomy from inception to 3 October 2022. Review methods Two authors independently extracted key data from the included studies. The methodological quality of the included studies was assessed using the A Measure Tool to Assess Systematic Reviews-2 checklist. Grading of Recommendations Assessment Development and Evaluation was used to evaluate the quality of the outcomes. Results A total of 18 studies with 29,925 patients were included, all of which were of critically low methodological quality. Biofeedback therapy seemed to show additional benefits compared to PFMT alone; however, the adjunctive role of electrical stimulation remained more controversial due to the lack of strong evidence. Preoperative PFMT sometimes, but not always, showed the potential to improve urinary incontinence. PFMT with the guidance of a therapist could bring some benefits to the patient and was more acceptable to the patient, but consumed some medical resources. Conclusions PFMT has a good effect on improving post-radical prostatectomy incontinence in men, and biofeedback can have an additional beneficial effect on patients, especially in the short-term and medium-term. However, there is insufficient evidence to suggest that electrical stimulation is beneficial for patients with urinary incontinence.

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Section: Methodological Qualitymentioning

confidence: 99%

Section: Methodological Qualitymentioning

confidence: 99%

“…Therefore, we eventually included 18 systematic reviews and meta-analyses in this article (Figure 1). [18][19][20][21][22][23][24][25][26][27][28][29][30][31][34][35][36][37]…”

Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Effect of pelvic floor muscle training on urinary incontinence after radical prostatectomy: An umbrella review of meta-analysis and systematic review

Yang

et al. 2022

Clin Rehabil

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“…Подолати депресію, тривогу в сучасних реаліях непросто: необхідно підібрати препарат, який комбінує антидепресивні властивості з анальгезивною дією, а також здатний покращувати нейропластичність та когнітивні здібності. Одним із найкращих рішень може стати призначення дулоксетину [13,14].…”

Section: вступunclassified

Особливості Фармакологічної Корекції Соматичних Проявів Депресії Та Когнітивного Зниження У Хворих Із Тривожно-Депресивними Розладами У Воєнний Час

2022

UMJ

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Зручність прийому -1 раз на добу 3 Доведена біоеквівалентність оригінальному дулоксетину 4 ДУЛОКСЕТИН ДУЛОКСИН ® Обери шлях ЯСКРАВОГО ЖИТТЯ Скорочена інструкція для медичного застосування препарату ДУЛОКСИН ® Склад: 1 капсула містить 33,7 мг дулоксетину гідрохлориду, що еквівалентно дулоксетину 30 мг, або 67,4 мг дулоксетину гідрохлориду, що еквівалентно дулоксетину 60 мг. Лікарська форма. Капсули кишковорозчинні тверді. Фармакотерапевтична група. Інші антидепресанти. Код АТХ N06A X21. Фармакологічні властивості. Дулоксетин -це комбінований інгібітор зворотного захоплення серотоніну і норепінефрину. Він незначною мірою інгібує захоплення допаміну, не має значної спорідненості з гістаміновими і допаміновими, холінергічними та адренергічними рецепторами. Механізм дії дулоксетину при лікуванні депресії зумовлений інгібуванням зворотного захоплення серотоніну і норепінефрину і, як наслідок, посиленням серотонінергічної і норадренергічної нейротрансмісії у центральній нервовій системі (ЦНС). Дулоксетин також чинить знеболювальну дію, що, імовірно, є результатом уповільнення передачі больових імпульсів у ЦНС. Показання. Лікування великих депресивних розладів. Лікування діабетичного периферичного нейропатичного болю. Лікування генералізованих тривожних розладів. Протипоказання. Підвищена чутливість до активної речовини або до будь-якої з допоміжних речовин препарату. Одночасне застосування дулоксетину з неселективними, незворотними інгібіторами моноаміноксидази (ІМАО) протипоказане. Захворювання печінки, які можуть спричинити печінкову недостатність. Дулоксетин не слід застосовувати у комбінації з флувоксаміном, ципрофлоксацином або еноксацином (сильні інгібітори CYP 1A2), оскільки комбінація призводить до підвищення концентрації дулоксетину в плазмі крові. Тяжка ниркова недостатність (кліренс креатиніну <30 мл/хв). Починати лікування дулоксетином протипоказано пацієнтам із неконтрольованою артеріальною гіпертензією, оскільки це може призвести до потенційного ризику гіпертонічного кризу.

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Assessing the efficacy of pelvic floor muscle training and duloxetine on urinary continence recovery following radical prostatectomy: A randomized clinical trial

Sanchez‐Salas,

Tourinho‐Barbosa,

Sivaraman

et al. 2023

The Prostate

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BackgroundUrinary incontinence (UI) can negatively impact quality of life (QoL) after robot‐assisted radical prostatectomy (RARP). Pelvic floor muscle training (PFMT) and duloxetine are used to manage post‐RARP UI, but their efficacy remains uncertain. We aimed to investigate the efficacy of PFMT and duloxetine in promoting urinary continence recovery (UCR) after RARP.MethodsA randomized controlled trial involving patients with urine leakage after RARP from May 2015 to February 2018. Patients were randomized into 1 of 4 arms: (1) PFMT‐biofeedback, (2) duloxetine, (3) combined PFMT‐biofeedback and duloxetine, (4) control arm. PFMT consisted of pelvic muscle exercises conducted with electromyographic feedback weekly, for 3 months. Oral duloxetine was administered at bedtime for 3 months. The primary outcome was prevalence of continence at 6 months, defined as using ≤1 security pad. Urinary symptoms and QoL were assessed by using a visual analogue scale, and validated questionnaires.ResultsFrom the 240 patients included in the trial, 89% of patients completed 1 year of follow‐up. Treatment compliance was observed in 88% (92/105) of patients receiving duloxetine, and in 97% (104/107) of patients scheduled to PFMT‐biofeedback sessions. In the control group 96% of patients had achieved continence at 6 months, compared with 90% (p = 0.3) in the PMFT‐biofeedback, 73% (p = 0.008) in the duloxetine, and 69% (p = 0.003) in the combined treatment arm. At 6 months, QoL was classified as uncomfortable or worse in 17% of patients in the control group, compared with 44% (p = 0.01), 45% (p = 0.008), and 34% (p = 0.07), respectively. Complete preservation of neurovascular bundles (NVB) (OR: 2.95; p = 0.048) was the only perioperative intervention found to improve early UCR.ConclusionsPFMT‐biofeedback and duloxetine demonstrated limited impact in improving UCR after RP. Diligent NVB preservation, along with preoperative patient and disease characteristics, are the primary determinants for early UCR.

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Efficacy of pelvic floor muscle exercise or therapy with or without duloxetine: a systematic review and network Meta-analysis

Cited by 5 publications

References 37 publications

Effect of pelvic floor muscle training on urinary incontinence after radical prostatectomy: An umbrella review of meta-analysis and systematic review

Effect of pelvic floor muscle training on urinary incontinence after radical prostatectomy: An umbrella review of meta-analysis and systematic review

Особливості Фармакологічної Корекції Соматичних Проявів Депресії Та Когнітивного Зниження У Хворих Із Тривожно-Депресивними Розладами У Воєнний Час

Assessing the efficacy of pelvic floor muscle training and duloxetine on urinary continence recovery following radical prostatectomy: A randomized clinical trial

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