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Effects of extracorporeal magnetic stimulation on urinary incontinence: A systematic review and meta-analysis.

AIMS
To examine the effectiveness of extracorporeal magnetic stimulation for treatment of stress urinary incontinence DESIGN: Systematic review and meta-analysis.


DATA RESOURCES
Four electronic databases from inception to 18 May 2019.


REVIEW METHODS
Two authors independently performed the search, assessed the methodological quality and extracted data. The final studies included in the analysis were selected after reaching consensus with the third author.


RESULTS
A total of 20 studies were included in the systematic review and 12 of these in the meta-analysis. Quality assessment indicated that only eight of 17 randomized controlled trials had low risk in overall risk of bias, whereas all controlled trials had serious risk of bias. The weighted mean effect size of magnetic stimulation on quality of life, number of leakages, pad test outcomes and number of incontinence events was 1.045 (95% CI: 0.409-1.681), -0.411 (95% CI: 0.178-0.643), -0.290 (95% CI: 0.025-0.556) and -0.747 (95% CI: -1.122 to -0.372), respectively. Subgroup analysis revealed a significant difference in the type of quality of life measurement used. Sensitivity analyses revealed that a high degree of heterogeneity persisted even after omitting studies individually.


CONCLUSIONS
Extracorporeal magnetic stimulation may be effective in treating urinary incontinence and improving quality of life without major safety concerns. However, because of a high degree of heterogeneity among studies, inferences from the results must be made with caution.


IMPACT
We recommend that clinical nurses apply extracorporeal magnetic stimulation to treat stress urinary incontinence among female patients and encourage researchers to conduct further qualitative and quantitative studies to develop consistent content and dosage for the intervention.


STUDY REGISTRATION
The review protocol was registered a priori and published online in the PROSPERO database of systematic reviews (www.crd.york.ac.uk/Prospero with the registration number #CRD42019138835).