لخّصلي

The success and effectiveness of treating UI with MS have been both subjectively and objectively proven in many studies.After analyzing over 300 articles, the systematic reviews by Lukanovic et al. and Antic et al. showed a need for further clinical trials to determine the entry criteria and diagnostic procedures for UI, and to standardize the MS treatment protocols.A meta-analysis by He et al., which examined 11 randomized controlled trials with a total of 612 patients, showed that MS is a method that decreases UI symptoms, alleviates UI frequency, increases the likelihood of becoming continent, and improves quality of life.In addition, the efficacy of treatment has been demonstrated objectively through urodynamic testing, which showed increased bladder volume at first sensation to void, along with increased maximum cystometric capacity and bladder compliance at maximum sensitivity [16,24].A meta-analysis by Peng et al., which looked at four randomized controlled trials involving a total 232 patients, showed a statistically significant improvement in symptoms in patients with SUI after MS therapy, without any detected side effects.They have mainly been proven subjectively through questionnaires, such as the Incontinence Quality of Life (I-QOL) questionnaire, which showed improved quality of life after treatment with MS, and the ICIQ-SF questionnaire, which demonstrated improvement in symptoms of UI and improved quality of life [23,24].The effectiveness of MS is influenced not only by clinical parameters (the severity and duration of illness, depression, etc.), but also various other factors (age, sex, financial status, etc.), which is why it should be assessed individually, together with the patient's medical history and clinical picture [26].Bradshaw et al. showed that the effects were only acute and not enduring, whereas Voorham-Vander Zalm et al. described post-treatment changes as statistically insignificant [34,35].Yamanishi et al. established that MS is an effective method of treating all types of UI, with recorded symptom improvements in 86% of SUI patients and 75% of UUI patients.The score of the ICIQ-UI-SF questionnaire decreased by 91% from the baseline, and the score of the ICIQ-OAB and IIQ-7 questionnaires decreased by 86% and 98%, respectively [29].They observed statistically significantly fewer leaks/3 days, less urine loss on a 24 h pad test, higher QoL scores, and lower ICIQ scores [31].Lopopolo et al. proved the effectiveness of MS without adverse side effects in patients with MUI.

The success and effectiveness of treating UI with MS have been both subjectively and objectively proven in many studies. They have mainly been proven subjectively through questionnaires, such as the Incontinence Quality of Life (I-QOL) questionnaire, which showed improved quality of life after treatment with MS, and the ICIQ-SF questionnaire, which demonstrated improvement in symptoms of UI and improved quality of life [23,24]. In addition, the efficacy of treatment has been demonstrated objectively through urodynamic testing, which showed increased bladder volume at first sensation to void, along with increased maximum cystometric capacity and bladder compliance at maximum sensitivity [16,24]. The effectiveness of treatment can also be assessed through a bladder diary analysis, which examines the frequency of urination and the level of urgency before and after therapy. The effectiveness of treating UI with MS is estimated to be between 29–53% and 86–94% for SUI and between 20–25% and 50–85% for UUI [20]. The effectiveness of MS is influenced not only by clinical parameters (the severity and duration of illness, depression, etc.), but also various other factors (age, sex, financial status, etc.), which is why it should be assessed individually, together with the patient’s medical history and clinical picture [26].
A meta-analysis by He et al., which examined 11 randomized controlled trials with a total of 612 patients, showed that MS is a method that decreases UI symptoms, alleviates UI frequency, increases the likelihood of becoming continent, and improves quality of life. It is especially well-suited to patients without sufficient motivation to perform regular pelvic floor muscle training [27]. Yamanishi et al. established that MS is an effective method of treating all types of UI, with recorded symptom improvements in 86% of SUI patients and 75% of UUI patients. Urodynamic testing showed that, in patients with SUI, the maximum intraurethral pressure increased by 34% during stimulation and maximum urethral closure pressure increased by 20.9%. In patients with UUI, significant increases in bladder capacities at first and maximum desire to void during stimulation were noted [20]. Similar findings were also presented by Lo et al., who reported that the efficacy of treatment with MS was 42.1% for SUI and 61.7% for OAB [28]. Lopopolo et al. proved the effectiveness of MS without adverse side effects in patients with MUI. The score of the ICIQ-UI-SF questionnaire decreased by 91% from the baseline, and the score of the ICIQ-OAB and IIQ-7 questionnaires decreased by 86% and 98%, respectively [29]. Gözlersüzer et al. concluded in their SR that MS treatment leads to an improvement in the symptoms of UI, in addition to associated improved quality of life for patients, without any reported side effects [30]. A meta-analysis by Peng et al., which looked at four randomized controlled trials involving a total 232 patients, showed a statistically significant improvement in symptoms in patients with SUI after MS therapy, without any detected side effects. They observed statistically significantly fewer leaks/3 days, less urine loss on a 24 h pad test, higher QoL scores, and lower ICIQ scores [31]. In turn, a systematic review by Antić et al. summarized the efficacy of UUI treatment with MS [5].
Among other things, many clinical trials have also studied long-term improvements after therapy with MS. Yamanishi et al. proved the long-term efficacy of treatment [20]. Similarly, Yokoyama et al. showed that MS cured or improved the condition in 17 out of 20 patients with UUI, and that 53% of patients continued to feel the effect of treatment 24 weeks after the last therapy [32]. Ünsal et al. demonstrated that, after 1 year of treatment, the efficacy of MS is comparable to that of surgery in SUI [33]. In contrast, Doğanay et al. concluded that the effects of treating both SUI and UUI with MS were only temporary, with a high (53%) recurrence rate at 6 months [26]. Bradshaw et al. showed that the effects were only acute and not enduring, whereas Voorham-Vander Zalm et al. described post-treatment changes as statistically insignificant [34,35]. Mikuš et al. recently conducted a randomized controlled trial on the efficacy between Kegel exercises and MS in the treatment of female SUI. They concluded that patients treated with MS had a lower number of incontinence episodes, a better quality of life and higher overall satisfaction with treatment than patients who performed Kegel exercises. No side effects were reported in both groups [36].
After analyzing over 300 articles, the systematic reviews by Lukanović et al. and Antić et al. showed a need for further clinical trials to determine the entry criteria and diagnostic procedures for UI, and to standardize the MS treatment protocols. In addition, longer follow-ups are needed. These are issues that should urgently be addressed in further clinical trials [5,23].