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Effectiveness of Telemedicine Interventions for Stress Urinary Incontinence in Women: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
Stress urinary incontinence (SUI) affects up to 30% of adult women worldwide, substantially impairing quality of life. Pelvic floor muscle training (PFMT) is the guideline-recommended first-line conservative treatment, but the requirement for face-to-face visits limits its widespread adoption. Telemedicine interventions offer a scalable alternative; however, their effectiveness for SUI remains to be clarified.
Objective:
Systematically evaluate the effectiveness of Telemedicine interventions for patients with SUI and and to identify sources of between -study heterogeneity.
Methods:
We systematically searched PubMed, Cochrane Library, Embase, and Web of Science from inception to April 12, 2026. Eligible studies were non–high-risk randomized controlled trials (RCTs) of telemedicine interventions for adult women with SUI or SUI -predominant urinary incontinence. The primary outcome was the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF). The secondary outcomes were included the disease-specific quality-of-life scale (ICIQ-LUTSQoL), the Patient Global Impression of Improvement (PGI-I), and the Urogenital Distress Inventory–Short Form (UDI-6). Risk of bias was assessed using the Cochrane RoB 2 tool. We conducted a pre-specified subgroup analysis by control type (passive versus active PFMT comparator).
Results:
9 RCTs involving approximately 830 women with SUI or SUI-predominant urinary incontinence were included. All studies were rated as low risk of bias or with some concerns. Compared with passive controls (no treatment, health education, or sham intervention; k=3), Telemedicine interventions significantly improved ICIQ-UI SF scores (mean difference [MD] =−4.07, 95% CI −6.63 to −1.50; P=.002; I²=80.0%). Compared with active PFMT controls (conventional PFMT delivery; k=3), Telemedicine interventions produced equivalent effects (MD=0.34, 95% CI −1.58 to 2.26; P=.729; I²=78.3%). The between-subgroup difference was significant (P=.005), with control type explaining 62.4% of the variance between studies. Telemedicine interventions significantly outperformed controls for UDI-6 (k=3; MD=−6.38, 95% CI −10.40 to −2.36; P=.002; I²=0%). For PGI-I (k=4), women receiving telehealth were approximately twice as likely to report meaningful subjective improvement (odds ratio [OR] 1.89, 95% CI 1.34 to 2.66; P<.001; I²=0%). No significant publication bias was detected (Egger P=.84).
Conclusions:
Telemedicine interventions significantly improve SUI symptoms compared with passive controls and are non-inferior to conventional PFMT delivery. Telemedicine interventions therefore represents an equivalent alternative for women who are unable or unwilling to receive in-person care. Clinical Trial: ROSPERO:CRD420261361399; https://www.crd.yo rk.ac.uk/PROSPERO/view/CRD420261361399
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