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array:24 [ "pii" => "S2173578620301505" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2020.12.002" "estado" => "S300" "fechaPublicacion" => "2021-01-01" "aid" => "1268" "copyright" => "AEU" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2021;45:73-82" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S021048062030098X" "issn" => "02104806" "doi" => "10.1016/j.acuro.2020.01.012" "estado" => "S300" "fechaPublicacion" => "2021-01-01" "aid" => "1268" "copyright" => "AEU" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2021;45:73-82" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo original</span>" "titulo" => "Entrenamiento muscular del suelo pélvico en el tratamiento del prolapso de órganos pélvicos: un metaanálisis de ensayos controlados aleatorizados" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "73" "paginaFinal" => "82" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pelvic floor muscle training in the treatment of pelvic organ prolapse: A meta-analysis of randomized controlled trials" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0030" "etiqueta" => "Figura 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 1258 "Ancho" => 2175 "Tamanyo" => 141393 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Forest plot</span> del CRADI-8 del grupo EMSP versus el grupo de control.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. 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Seguimiento a cinco años" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1329 "Ancho" => 1524 "Tamanyo" => 104843 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Survival curve without CIC.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Morán, I. Sáez, J. Bolón, O. Colet, M.A. Bonillo, E. Martínez-Cuenca, E. Broseta, S. Arlandis" "autores" => array:8 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Morán" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Sáez" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Bolón" ] 3 => array:2 [ "nombre" => "O." "apellidos" => "Colet" ] 4 => array:2 [ "nombre" => "M.A." "apellidos" => "Bonillo" ] 5 => array:2 [ "nombre" => "E." "apellidos" => "Martínez-Cuenca" ] 6 => array:2 [ "nombre" => "E." "apellidos" => "Broseta" ] 7 => array:2 [ "nombre" => "S." "apellidos" => "Arlandis" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480620301881" "doi" => "10.1016/j.acuro.2020.08.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480620301881?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578620301530?idApp=UINPBA00004N" "url" => "/21735786/0000004500000001/v1_202101060759/S2173578620301530/v1_202101060759/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173578620301517" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2020.12.003" "estado" => "S300" "fechaPublicacion" => "2021-01-01" "aid" => "1283" "copyright" => "AEU" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2021;45:64-72" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Is the addition of vaginal electrical stimulation to transcutaneous tibial nerve electrical stimulation more effective for overactive bladder treatment? 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Un ensayo controlado aleatorizado" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2392 "Ancho" => 2500 "Tamanyo" => 207668 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Flowchart of the study.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F. Bacchi Ambrosano Giarreta, J. Milhem Haddad, H.C. Souza de Carvalho Fusco, E. Chada Baracat, R.A. Casarotto, E. Alves Gonçalves Ferreira" "autores" => array:6 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "Bacchi Ambrosano Giarreta" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Milhem Haddad" ] 2 => array:2 [ "nombre" => "H.C." "apellidos" => "Souza de Carvalho Fusco" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Chada Baracat" ] 4 => array:2 [ "nombre" => "R.A." "apellidos" => "Casarotto" ] 5 => array:2 [ "nombre" => "E." "apellidos" => "Alves Gonçalves Ferreira" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480620301285" "doi" => "10.1016/j.acuro.2020.03.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480620301285?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578620301517?idApp=UINPBA00004N" "url" => "/21735786/0000004500000001/v1_202101060759/S2173578620301517/v1_202101060759/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Pelvic floor muscle training in the treatment of pelvic organ prolapse: A meta-analysis of randomized controlled trials" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "73" "paginaFinal" => "82" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Ge, X.J. Wei, H.Z. Zhang, G.Y. Fang" "autores" => array:4 [ 0 => array:3 [ "nombre" => "J." "apellidos" => "Ge" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "X.J." "apellidos" => "Wei" "email" => array:1 [ 0 => "3025300877@qq.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "H.Z." "apellidos" => "Zhang" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "G.Y." "apellidos" => "Fang" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Obstetrics, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Gynecology and Obstetrics, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Entrenamiento muscular del suelo pélvico en el tratamiento del prolapso de órganos pélvicos: un metaanálisis de ensayos controlados aleatorizados" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1319 "Ancho" => 2099 "Tamanyo" => 181294 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The flow diagram of the literature search and selection process.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Pelvic organ prolapse (POP) is characterized by the descent of pelvic organs from their normal positions, such as the anterior or posterior vaginal wall, vaginal vault, or the uterus from their normal positions.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The American College of Obstetricians and Gynecologists define POP as the prolapse of organs with the pelvis into or downwards outside of the vaginal canal.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> POP includes prolapse of the apical segment of the vagina, the posterior vaginal wall (enterocele or rectocele) and the anterior vaginal wall (cystocele or urethrocele).<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> POP is categorized by severity into 5 stages (stage 0, 1, 2, 3, and 4).<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> The current prevalence of symptomatic prolapse is reported to be 3–12%, and about 40% of women older than 50 years have different degrees of POP, and women aged 45–85 years have up to 75% chance to suffer from prolapse.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Typical POP symptoms appear when the organ has prolapsed beyond or reached the hymen. POP symptoms include mass or protrusion, bowel symptoms, pelvic severity, lumbar pain, swelling coming downwards from the vagina, feeling of heaviness in the vagina, concurrent bladder symptoms, sexual symptoms, or pelvic pressure/heaviness. These symptoms may be associated with organ prolapse or occur with or without the prolapse. Treatment options include pessary treatment, mechanical support, physiotherapy and rehabilitation program, as well as surgical correction. Nonetheless, surgery could cause many problems and complications accompanied with frailty and comorbidity, making it hard to proceed. Physiotherapy and rehabilitation programs consist of several exercises, which are established to strengthen pelvic floor support and muscles, and to promote electric stimulation and biofeedback. The physiotherapy and rehabilitation approaches aim to increase the support, endurance, as well as the strength of the pelvic floor muscles, and to prevent deterioration of prolapse, which can also decrease the frequency and severity of symptoms that are caused by prolapse to prevent or delay surgery.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,8</span></a> It is always crucial to note that pelvic floor muscular training (PFMT) is considered as one of the most pivotal physiotherapeutic and rehabilitation approaches for women with POP to exercise pelvic floor muscles.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9,10</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Therefore, in this meta-analysis, we searched for and identified eligible literature to collect current evidence on the overall effect of PFMT for female patients with POP.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Search strategy</span><p id="par0020" class="elsevierStylePara elsevierViewall">The Cochrane, PubMed, and Embase were searched for all the randomized controlled trials concerning the efficacy of PFMT in the treatment of women with POP. Other relevant publications as well as reference materials that updated to December 2018 were identified. The literature search process was performed independently by two reviewers. Any differences were solved <span class="elsevierStyleItalic">via</span> the help of a third reviewer.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Eligibility criteria</span><p id="par0025" class="elsevierStylePara elsevierViewall">To be included in this analysis, studies should meet the following criteria: (1) randomized control trial (RCT); (2) the research subjects were female with POP without other serious diseases; (3) the treatment group received PFMT, and the control group received standard treatment or other relative medicine; (4) only articles published in English were included. The study was also developed according to PICOS definitions: P (patients with pelvic organ prolapse), I (pelvic floor muscle training), C (compared the PFMT with standard treatment or other relative medicine), O (POP-Q stage change, Self-reported change in symptoms, POP-SS, POPDI-6, CRADI-8 and UDI-6), S (only included RCTs).</p><p id="par0030" class="elsevierStylePara elsevierViewall">Studies that met the following criteria were excluded from the meta-analysis: (1) duplication publication of the same result or content; (2) mistakes showed in data; (3) economic analysis, meta-analysis, theoretical research, conference report, expert comment, systematic review, and case report; (4) irrelevant outcomes.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The two reviewers searched and screened the studies independently to identify predefined criteria. Any disagreement was resolved through the help of a third reviewer.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Data extraction and eligibility</span><p id="par0040" class="elsevierStylePara elsevierViewall">We extracted data from all the included studies, consisting of basic information and main outcomes. The names of authors, the publication year, the Jadad score, the sample size, the interventions of the treatment and control group, percentage of females, and the average age were extracted as the basic information. Clinical outcomes, such as pelvic organ prolapse quantification (POP-Q) stage change, self-reported change in symptoms, pelvic organ prolapse distress inventory-6 (POPDI-6), pelvic floor prolapse symptom score (POP-SS), urinary distress inventory-6 (UDI-6), and colorectal anal distress inventory-8 (CRADI-8) were used for evaluation. The Jadad scoring checklist was used to appraise the quality of involved studies. We evaluated all the RCTs from the five items: appropriateness of generating randomized sequence; randomization statement; description and use of double blind method; detail of withdrawals and dropouts. Studies with a score of less than 3 represented low-quality and high bias risk studies, studies with a score exceeding 3 were considered as high-quality trials. The process was performed by two investigators separately; differences were settled through discussion.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0045" class="elsevierStylePara elsevierViewall">We utilized the STATA 10.0 (TX, USA) to perform all statistical analyses. To assess the heterogeneity of studies and determine the model for analysis (random-effects model or fixed-effects model), <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> tests and Chi-squared test were conducted. When the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test value was more than 50% and Chi-squared test <span class="elsevierStyleItalic">p</span>-value was less than 0.05, heterogeneity was defined to be high and the random-effects model was used to assess the study. When the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test value was less than 50% and Chi-squared test <span class="elsevierStyleItalic">p</span>-value was more than 0.05, heterogeneity was defined as acceptable and the fixed-effects model was used to assess the study. Continuous variables were expressed as mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>standard deviation and analyzed by mean difference (MD). Categorical data were presented as percentages and analyzed by relative risk (RR) or odds ratio (OR). The change of POP-Q stage and self-reported symptoms were analyzed by OR and 95%CI. MD along with 95%CI was used to analyze POP-SS, POPDI-6, CRADI-8, and UDI-6.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Study characteristics</span><p id="par0050" class="elsevierStylePara elsevierViewall">A total of 1349 articles were included by the index words. During preliminary screening of abstracts and titles, 1297 records were eliminated, leaving 52 publications for further assessment. After full-text search and screening, 37 records were excluded due to the following exclusion criteria: non-RCT (8), theoretical or economic research (19), and no clinical outcomes (10). Finally, 15 studies<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11–25</span></a> with 1309 patients in the PFMT group and 1275 patients in the control group were included in this meta-analysis. <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> shows the detailed search process.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The major features of all included studies are presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. All the studies adopted PFMT in the treatment group, and in the control group, nine studies adopted lifestyle advice, two studies adopted watchful waiting, one study adopted stabilization exercise, one study adopted pessary treatment, and one study adopted support device. The basic information included age and BMI. The main Jadad score of included studies was 3.5, eight studies got 3 and seven studies got 4. The main score exceeded 3, which indicated high quality for the 15 included RCTs.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">POP-Q stage change</span><p id="par0060" class="elsevierStylePara elsevierViewall">Six trials with 416 female patients in the PFMT group and 402 female patients in the control group reported POP-Q stage change. Based on the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test-value (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0%<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>50%) and Chi-squared test <span class="elsevierStyleItalic">p</span>-value (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.388<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05), we chose the fixed effects model to analyze POP-Q stage change of add 2 stages. The pooled results showed no remarkable difference in the incidence of add 2 POP-Q stages (RR: 0.55, 95%CI: 0.19–1.63, <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) between the PFMT group and the control group. Based on the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test-value (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>13.7%<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>50%) and Chi-squared test <span class="elsevierStyleItalic">p</span>-value (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.324<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05), we chose the fixed effects model to analyze the POP-Q stage change of add 1 stages. The pooled results showed no remarkable difference in the incidence of add 1 POP-Q stages (RR: 1.04, 95%CI: 0.69–1.57, <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) when comparing the PFMT group with the control group. Based on the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test-value (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>48.5%<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>50%) and Chi-squared test <span class="elsevierStyleItalic">p</span>-value (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.100<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05), we chose the fixed effects model to analyze the POP-Q stage change of no change. The pooled results showed no remarkable difference in the incidence of no POP-Q stage change (RR: 0.94, 95%CI: 0.81–1.09, <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) between the PFMT group and the control group. Based on the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test value (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>52.4%) and Chi-squared test <span class="elsevierStyleItalic">p</span>-value (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.122<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05), we chose the fixed effects model to analyze POP-Q stage change of reduce 1 stages. The pooled results showed that the incidence of reduce 1 POP-Q stages was significantly higher in the PFMT group than that in the control group (RR: 1.80, 95%CI: 1.20–2.69, <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Based on the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test value (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0%<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>50%) and Chi-squared test <span class="elsevierStyleItalic">p</span>-value (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.859<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05), we chose the fixed effects model to analyze the POP-Q stage change of reduce 2 stages. The pooled results showed no remarkable difference in the incidence of reduce 2 POP-Q stages (RR: 1.72, 95%CI: 0.79–3.76, <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) between the PFMT group and the control group.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Self-reported change in symptoms</span><p id="par0065" class="elsevierStylePara elsevierViewall">Five trials with 529 female patients in the PFMT group and 523 patients in the control group reported self-reported change in symptoms. Based on the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test value (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>76.6%<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>50%) and Chi-squared test <span class="elsevierStyleItalic">p</span>-value (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.002<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05), we chose the random effects model to analyze the self-reported better symptom change after treatment. The pooled results showed that the PFMT significantly changed the self-reported symptoms in better comparison with the control group (RR: 2.90, 95%CI: 1.72–4.89, <a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). Based on the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test value (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>76.6%<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>50%) and Chi-squared test <span class="elsevierStyleItalic">p</span>-value (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.002<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05), we chose the random effects model to analyze the self-reported same symptom change after treatment. The pooled results showed no remarkable difference in the incidence of self-reported same symptom change between the two groups (RR: 0.70, 95%CI: 0.45–1.09, <a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). Based on the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test value (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>77.4%<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>50%) and Chi-squared test <span class="elsevierStyleItalic">p</span>-value (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.004<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05), we chose the random effects model to analyze the self-reported worse symptom change after treatment. The pooled results showed no significant difference between the two groups (RR: 0.67, 95%CI: 0.22–2.03, <a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>) in the incidence of self-reported worse symptom change.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">POP-SS</span><p id="par0070" class="elsevierStylePara elsevierViewall">Five trials with 490 female patients in the PFMT group and 489 female patients in the control group reported POP-SS results. Based on the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test value (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>88.7%<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>50%) and Chi-squared test <span class="elsevierStyleItalic">p</span>-value (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.00<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05), we chose the random effects model to analyze POP-SS. The pooled results showed no distinct difference between the two groups (SMD: −0.24, 95%CI: −0.71 to 0.22, <a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>) in the change of POP-SS after the therapy.</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">POPDI-6</span><p id="par0075" class="elsevierStylePara elsevierViewall">Four trials with 426 patients in the PFMT group and 419 patients in the control group reported the POPDI-6 results. Based on the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test value (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>76.9%<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>50%) and Chi-squared test <span class="elsevierStyleItalic">p</span>-value (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.005<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05), we chose the random effects model to analyze the POPDI-6. The pooled results showed no significant difference between the two groups (SMD: −0.14, 95%CI: −0.43 to 0.15, <a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>) in the change of POPDI-6 after the therapy.</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">CRADI-8</span><p id="par0080" class="elsevierStylePara elsevierViewall">Four trials with 426 patients in the PFMT group and 419 patients in the control group reported the CRADI-8 results. Based on the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test value (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>40.2%<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>50%) and Chi-squared test <span class="elsevierStyleItalic">p</span>-value (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.171<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05), we chose the fixed effects model to analyze POP-SS. The pooled results showed no significant difference between the two groups (SMD: −0.03, 95%CI: −0.16 to 0.11, <a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>) in the change of CRADI-8 after the therapy.</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">UDI-6</span><p id="par0085" class="elsevierStylePara elsevierViewall">Four trials with 426 patients in the PFMT group and 419 patients in the control group reported UDI-6 results. Based on the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test value (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>72.2%<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>50%) and Chi-squared test <span class="elsevierStyleItalic">p</span>-value (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.013<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05), we chose the random effects model to analyze UDI-6. The pooled results indicated no remarkable difference between the two groups (SMD: −0.17, 95%CI: −0.43 to 0.10, <a class="elsevierStyleCrossRef" href="#fig0035">Fig. 7</a>) in the change of UDI-6 after the therapy.</p><elsevierMultimedia ident="fig0035"></elsevierMultimedia></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Quality assessment and potential bias</span><p id="par0090" class="elsevierStylePara elsevierViewall">According to the inclusion and exclusion criteria that were described earlier, 15 publications were included in this meta-analysis. The eligibility and bias risk of trials were evaluated and calculated by funnel plot, Begg's and Mazumdar's rank test, as well as the Egger's test. The funnel plot in terms of log SMD in UDI-6 of the included studies was notably symmetrical, indicating no significant publication bias (<a class="elsevierStyleCrossRef" href="#fig0040">Fig. 8</a>). Significant symmetry was also detected using Begg's and Mazumdar's rank test (<span class="elsevierStyleItalic">Z</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.02, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.308). However, the Egger's test showed no significant publication bias (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.172).</p><elsevierMultimedia ident="fig0040"></elsevierMultimedia></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">In this meta-analysis, we included 15 RCTs with a mean Jada score of 3.5. Compared with conventional treatments, PFMT has significant therapeutic effect on reducing 1 POP-Q stages (RR: 1.80, 95%CI: 1.20–2.69), the self-reported better symptoms (RR: 2.90, 95%CI: 1.72–4.89), decreasing POP-SS (SMD: −0.24, 95%CI: −0.71 to 0.22), POPDI-6 (SMD: −0.14, 95%CI: −0.43 to 0.15), CRADI-8 (SMD: −0.03, 95%CI: −0.16 to 0.11), and UDI-6 (SMD: −0.17, 95%CI: −0.43 to 0.10). However, there still was no statistical difference in some aspects of add 2 POP-Q stages (RR: 0.55, 95%CI: 0.19–1.63), add 1 POP-Q stages (RR: 1.04, 95%CI: 0.69–1.57), no POP-Q stage change (RR: 0.94, 95%CI: 0.81–1.09), reduce 2 POP-Q stages (RR: 1.72, 95%CI: 0.79–3.76), self-reported same symptom change (RR: 0.70, 95%CI: 0.45–1.09), and self-reported worse symptom change (RR: 0.67, 95%CI: 0.22–2.03) between the two groups.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Li et al.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> showed similar results earlier based on 13 studies. They found that women receiving PFMT can significantly improve the prolapse symptom score and POP stages <span class="elsevierStyleItalic">versus</span> the control group. The women who received PFMT had fewer syndromes of prolapse with lower chance of discomfort with the rectum, vagina, as well as the bladder. PFMT also improved muscle endurance and strength; however, no significant difference was observed. Additionally, it was still inconclusive that PFMT should be regarded as an alternative method for prolapse surgery due to variability of outcomes. Several latest evidence<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,8,11</span></a> indicated that PFMT had beneficial effect for female with urinary incontinence or symptomatic mild prolapse. Studies indicated that through pelvic floor muscles contraction during and before the increase of abdominal pressure, PFMT can support the pelvic organ in the normal anatomic position effectively.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12,13</span></a> Based on a review from Cochrane, PFMT should be considered as one of the first-line conservative managements for patients with stress urinary incontinence.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9,10</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Our results showed that PFMT had a positive effect on prolapse symptoms for female patients with POP when compared with controls. Nevertheless, heterogeneity existed in the mentioned trials, making data interpretation even harder. Additionally, our present study only included small sample size, which led to potential bias of the results. Recommendation is that the position of the rectum and bladder is considered as markers to indicate the severity of anterior and posterior compartment prolapse. Two of the most discriminatory symptoms are vaginal heaviness and bulging in female harboring POP. Remarkable improvement was observed in our findings in female with PFMT in the bowel, bladder, as well as vaginal bulging syndromes with association of better life quality. As the mentioned symptoms are the major indicators for prolapse surgery, the beneficial effect in the vagina, bowel, and bladder is regarded as the most crucial treatment targets.</p><p id="par0110" class="elsevierStylePara elsevierViewall">Pelvic floor muscle training makes pelvic floor muscle passive movement, active pelvic floor blood circulation, exercise anal, abdominal muscle, hip muscle. Pelvic floor muscle training strengthens the tension of uterine ligament, bladder cervical ligament, pelvic floor fascia, and promotes the contraction of smooth muscle of uterus. What's more, it strengthens the contraction of levator ANI and distal urethral sphincter, and the ability of urine control; training stimulates pelvic floor nerves, maintains and restores the shape and function of motor organs, and promotes the formation and development of compensatory mechanisms. The pelvic floor nerve changes (such as increased effective motor units and excitation frequency), muscle contraction and tension are strengthened to provide structural support for the urinary bladder and urethra. It can effectively prevent the occurrence of postpartum urinary incontinence and improve postpartum pelvic floor muscle strength. Like other common physical exercises, persistence is the most important principle for pelvic floor muscle training, because muscle fiber enlargement is a slow process, and only prolonged exercise can produce and maintain benefits.</p><p id="par0115" class="elsevierStylePara elsevierViewall">Some advantages of the present meta-analysis are as follows: the findings of this systemic review might be more convincing than any individual study among all included RCTs because the effect of PFMT in patients with POP was quantitatively determined using a pooled large sample size; and this meta-analysis provided evidence for the effects of PFMT; the strict inclusion and exclusion criteria were used to selected the eligible studies; all the data were analyzed by standard statistical analysis to confirm the results’ accuracy.</p><p id="par0120" class="elsevierStylePara elsevierViewall">Nonetheless, there were several limitations in our review: (1) only RCTs were involved; (2) the predefined criteria were variable for patients in different studies; (3) patients with other diseases and therapy were not available; (4) most trials with low quality and low Jadad score were included in our study; (5) various treatment time such as short-term, intermediate-time, long-term; (6) the frequency, intensity and duration of PFMT procedures; (7) we used pooled data for analyses with unavailable individual data, which limited more comprehensive analyses.</p><p id="par0125" class="elsevierStylePara elsevierViewall">In conclusion, the present study indicated that compared to the control group, PFMT significantly decreased the POP-Q stage with beneficial effect and increased POP-SS score. Thus, further high-quality studies with a larger sample size as well as longer follow-up are warranted to confirm the current findings and conclusions.</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflict of interest</span><p id="par0130" class="elsevierStylePara elsevierViewall">The authors declare that there are no conflicts of interests.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres1445120" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1318539" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1445119" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1318540" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Search strategy" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Eligibility criteria" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Data extraction and eligibility" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0035" "titulo" => "Results" "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Study characteristics" ] 1 => array:2 [ "identificador" => "sec0045" "titulo" => "POP-Q stage change" ] 2 => array:2 [ "identificador" => "sec0050" "titulo" => "Self-reported change in symptoms" ] 3 => array:2 [ "identificador" => "sec0055" "titulo" => "POP-SS" ] 4 => array:2 [ "identificador" => "sec0060" "titulo" => "POPDI-6" ] 5 => array:2 [ "identificador" => "sec0065" "titulo" => "CRADI-8" ] 6 => array:2 [ "identificador" => "sec0070" "titulo" => "UDI-6" ] 7 => array:2 [ "identificador" => "sec0075" "titulo" => "Quality assessment and potential bias" ] ] ] 7 => array:2 [ "identificador" => "sec0080" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0085" "titulo" => "Conflict of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-02-07" "fechaAceptado" => "2020-01-19" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1318539" "palabras" => array:4 [ 0 => "Pelvic organ prolapse" 1 => "Pelvic muscle training" 2 => "Randomized controlled trial" 3 => "Meta-analysis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1318540" "palabras" => array:4 [ 0 => "Prolapso de órganos pélvicos" 1 => "Entrenamiento de los músculos pélvicos" 2 => "Ensayo controlado aleatorizado" 3 => "Metaanálisis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">We aimed to assess the overall effect of pelvic muscle training (PFMT) on patients with pelvic organ prolapse (POP) based on eligible randomized controlled trials (RCT).</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">We searched the following databases, such as PubMed, Cochrane, and Embase, to identify eligible RCT based on the index words updated to December 2018. We also searched the publications related to the present study. Odds rations (OR), and mean difference (MD) along with 95% confidence interval (95%CI) were used to analyze the main outcomes.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">In this meta-analysis, 15 RCTs were included with a total of 1309 patients in the PFMT group and a total of 1275 patients in the control group. The overall results showed no significant difference in the incidence of add 2 POP-Q stages (RR: 0.55, 95%CI: 0.19–1.63), add 1 POP-Q stages (RR: 1.04, 95%CI: 0.69–1.57), no POP-Q stages change (RR: 0.94, 95%CI: 0.81–1.09), reduce 2 POP-Q stages (RR: 1.72, 95%CI: 0.79–3.76), self-reported same symptom change (RR: 0.70, 95%CI: 0.45–1.09), and self-reported worse symptom change (RR: 0.67, 95%CI: 0.22–2.03) between the 2<span class="elsevierStyleHsp" style=""></span>groups. Besides, the incidence of reduce 1 POP-Q stages was significantly higher in the PFMT group than that of the control group (RR: 1.80, 95%CI: 1.20–2.69), and the PFMT significantly changed the self-reported symptoms with better outcomes when compared with the control group (RR: 2.90, 95%CI: 1.72–4.89). However, after the therapy, the PFMT group decreased the POP-SS (SMD: −0.24, 95%CI: −0.71 to 0.22), POPDI-6 (SMD: −0.14, 95%CI: −0.43 to 0.15), CRADI-8 (SMD: −0.03, 95%CI: −0.16 to 0.11), and UDI-6 (SMD: −0.17, 95%CI: −0.43 to 0.10) <span class="elsevierStyleItalic">versus</span> the control group, but without statistical significance.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">PMFT showed better effect in reducing 1 POP-Q stages, changing the self-reported symptoms with better outcomes, decreasing the score of POP-SS, POPDI-6, CRADI-8, and UDI-6 in women with POP <span class="elsevierStyleItalic">versus</span> the control group. However, more high-quality multicenter RCTs with a larger sample size are needed to confirm the present conclusions.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">El objetivo fue evaluar el efecto general del entrenamiento muscular del suelo pélvico (EMSP) en pacientes con prolapso de órganos pélvicos (POP) con base en una selección de ensayos controlados aleatorizados (ECA).</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Se realizaron búsquedas en bases de datos, como PubMed, Cochrane y Embase, para identificar ECA elegibles en función de las palabras indexadas, actualizadas en diciembre del 2018. También buscamos en publicaciones relacionadas con el presente estudio. Los resultados principales se analizaron usando <span class="elsevierStyleItalic">odds ratio</span> (OR) y la diferencia media (DM), con un intervalo de confianza del 95% (IC del 95%).</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">En este metaanálisis se incluyeron 15 ECA, con un total de 1.309 pacientes en el grupo de EMSP y un total de 1.275 pacientes en el grupo de control. Los resultados generales no mostraron diferencias significativas entre los 2<span class="elsevierStyleHsp" style=""></span>grupos en la incidencia del aumento de 2 grados POP-Q (RR: 0,55, IC del 95%: 0,19-1.63), aumento de 1 grado POP-Q (RR: 1.04, IC del 95%: 0,69-1,57), ausencia de cambio de grado POP-Q (RR: 0,94, IC del 95%: 0,81-1,09), reducción de 2 grados POP-Q (RR: 1,72, IC del 95%: 0,79-3,76), ausencia de cambio en los síntomas reportada por las propias pacientes (RR: 0,70, IC del 95%: 0,45-1,09) y cambio a peor en los síntomas reportado por las propias pacientes (RR: 0,67, IC del 95%: 0,22-2,03). Además, la incidencia de la reducción de 1 grado POP-Q fue significativamente mayor en el grupo de EMSP que en el grupo de control (RR: 1,80, IC del 95%: 1,20-2,69) y el EMSP cambió significativamente los síntomas informados por las pacientes produciendo mejores resultados en comparación con el grupo de control (RR: 2,90, IC del 95%: 1,72-4,89). Sin embargo, después de la terapia, los resultados del grupo de EMSP disminuyeron frente al grupo de control en las siguientes pruebas: POP-SS (SMD: −0,24, IC del 95%: −0,71-0,22), POPDI-6 (SMD: −0,14, IC del 95%: −0,43-0,15), CRADI-8 (SMD: −0,03, IC del 95%: −0,16-0,11) y UDI-6 (SMD: −0,17, IC del 95%: −0,43-0,10), pero sin significación estadística.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">El EMSP tuvo un mejor efecto en la reducción de 1 grado de POP-Q, con mejores resultados en los síntomas reportados por los pacientes, disminuyendo el puntaje POP-SS, POPDI-6, CRADI-8 y UDI-6 en las mujeres con POP versus el grupo de control. Sin embargo, se necesitan más ECA multicéntricos de alta calidad con un tamaño de muestra mayor para confirmar las presentes conclusiones.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Ge J, Wei XJ, Zhang HZ, Fang GY. Entrenamiento muscular del suelo pélvico en el tratamiento del prolapso de órganos pélvicos: un metaanálisis de ensayos controlados aleatorizados. Actas Urol Esp. 2021;45:73–81.</p>" ] ] "multimedia" => array:9 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1319 "Ancho" => 2099 "Tamanyo" => 181294 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The flow diagram of the literature search and selection process.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2804 "Ancho" => 2925 "Tamanyo" => 880788 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Forest plot of changes in POP-Q stage of the PFMT group <span class="elsevierStyleItalic">versus</span> the control group.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1741 "Ancho" => 2175 "Tamanyo" => 360560 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0035" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Forest plot of self-reported change in symptoms of the PFMT group <span class="elsevierStyleItalic">versus</span> the control group.</p>" ] ] 3 => array:8 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1285 "Ancho" => 2175 "Tamanyo" => 160557 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0040" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Forest plot of POP-SS of the PFMT group <span class="elsevierStyleItalic">versus</span> the control group.</p>" ] ] 4 => array:8 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1141 "Ancho" => 2175 "Tamanyo" => 160900 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0045" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Forest plot of POPDI-6 of the PFMT group <span class="elsevierStyleItalic">versus</span> the control group.</p>" ] ] 5 => array:8 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 1172 "Ancho" => 2175 "Tamanyo" => 134530 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0050" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Forest plot of CRADI-8 of the PFMT group <span class="elsevierStyleItalic">versus</span> the control group.</p>" ] ] 6 => array:8 [ "identificador" => "fig0035" "etiqueta" => "Figure 7" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr7.jpeg" "Alto" => 1134 "Ancho" => 2175 "Tamanyo" => 134296 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0055" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Forest plot of UDI-6 of the PFMT group <span class="elsevierStyleItalic">versus</span> the control group.</p>" ] ] 7 => array:8 [ "identificador" => "fig0040" "etiqueta" => "Figure 8" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr8.jpeg" "Alto" => 955 "Ancho" => 1341 "Tamanyo" => 70809 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0060" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Funnel plot of studies in the meta-analysis.</p>" ] ] 8 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0065" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Study \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Therapy</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No. of patients</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">BMI</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Jadad score \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Duration of PFMT \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">The index measurement time \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">T \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">C \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">T \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">C \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">T \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">C \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">T \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">C \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Matthew D. Barber, 2014 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>behavioral therapy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Usual care \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">186 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">188 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Suzanne Hagen, 2014 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lifestyle advice \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">225 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">222 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Doreen McClurg, 2014 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lifestyle advice \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Marian Wiegersma, 2014 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Watchful waiting \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">145 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">142 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ingeborg Hoff Brækken, 2010 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>lifestyle advice \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lifestyle advice \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Suzanne Hagen, 2008 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>lifestyle advice \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lifestyle advice \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Liliana Stüpp, 2011 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lifestyle advice \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52.95 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nuriye Ozengin, 2014 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stabilization exercise \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47.52 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43.68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.03 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ulla Due, 2016 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT+lifestyle advice \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lifestyle advice \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bruno Teixeira Bermardes, 2012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lifestyle advice \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">51.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Boudewijn J Kollen, 2016 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pessary treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">82 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gunvor Hilde, 2015 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lifestyle advice \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">87 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sinclair L, 2006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Support device \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CMCR Panman, 2016 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Watchful waiting \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">145 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">142 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cathryn Glazener, 2016 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PFMT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lifestyle advice \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">206 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">206 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 months \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2485392.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The basic characteristics description of included studies.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K. 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