Table BClinical outcomes with treatments for UI (pooled with random effects estimates from head-to-head RCTs)

TreatmentsOutcomesNumber of studiesPatientsRate, % active/ controlRelative risk (95% CI)Absolute risk difference* (95% CI)Number needed to treat (95% CI)Attributable events (95% CI)Effect in relative/ absolute scaleEvidence
Pharmacological treatments for stress UI
Duloxetine vs. placeboContinence273638/400.92
(0.86 to 0.99)
−0.03
(−0.12 to 0.06)
↓/NSLow
Duloxetine vs. placeboImproved UI41,13837/291.68
(0.94 to 3.00)
0.08
(0.01 to 0.14)
13
(7 to 143)
75
(7 to 142)
NS/↑High
Duloxetine vs. placeboDiscontinuation due to adverse effects93,25216/34.4
(3.24 to 5.86)
0.13
(0.06 to 0.19)
8
(5 to 16)
129
(64 to 193)
High
Pharmacological treatments for urgency UI
Darifenacin vs. placeboImproved UI31,01148/331.3
(1.2 to 1.5)
0.12
(0.06 to 0.17)
9
(6 to 18)
117
(57 to 177)
High
Darifenacin vs. placeboDiscontinuation due to adverse effects73,1385/31.2
(0.8 to 1.8)
0.00
(−0.01 to 0.02)
NSHigh
Darifenacin vs. placeboDiscontinuation due to failure41,2801/20.6
(0.2 to 1.7)
−0.01
(−0.02 to 0.01)
NSModerate
Fesoterodine vs. placeboContinence22,46561/481.3
(1.1 to 1.5)
0.13
(0.06 to 0.20)
8
(5 to 17)
130
(58 to 202)
Low
Fesoterodine vs. placeboImproved UI21,89642/321.3
(1.2 to 1.5)
0.10
(0.06 to 0.15)
10
(7 to 18)
100
(56 to 145)
High
Fesoterodine vs. placeboAdverse effects44,14551/381.4
(1.2 to 1.6)
0.16
(0.11 to 0.20)
6
(5 to 9)
156
(112 to 200)
High
Fesoterodine vs. placeboDiscontinuation due to adverse effects44,4336/32.0
(1.3 to 3.1)
0.03
(0.01 to 0.06)
33
(18 to 102)
31
(10 to 56)
High
Fesoterodine vs. placeboDiscontinuation due to failure21,8962/30.6
(0.2;2.5)
−0.01
(−0.03 to 0.02)
NSModerate
Oxybutynin vs. placeboContinence499227/161.7
(1.3 to 2.1)
0.11
(0.06 to 0.16)
9
(6 to 16)
114
(64 to 163)
High
Oxybutynin vs. placeboImproved UI91,24453/321.5
(1.2 to 1.9)
0.17
(0.10 to 0.24)
6
(4 to 11)
167
(95 to 240)
Moderate
Oxybutynin vs. placeboDiscontinuation due to adverse effects51,48310/51.7
(1.1 to 2.5)
0.06
(0.01 to 0.13)
16
(8 to 86)
63
(12 to 127)
High
Propiverine vs. placeboContinence269153/371.4
(1.2 to 1.7)
0.16
(0.09 to 0.24)
6
(4 to 12)
163
(86 to 239)
Low
Propiverine vs. placeboImproved UI398555/351.6
(1.3 to 2.0)
0.19
(0.13 to 0.25)
5
(4 to 8)
192
(132 to 252)
Moderate
Propiverine vs. placeboDiscontinuation due to adverse effects21,4015/22.6
(1.4 to 5.00)
0.03
(0.01 to 0.06)
29
(16 to 77)
34
(13 to 61)
Low
Solifenacin vs. placeboContinence56,30439/281.5
(1.4 to 1.6)
0.11
(0.06 to 0.16)
9
(6 to 17)
107
(58 to 156)
High
Solifenacin vs. placeboImproved UI21,50760/421.5
(1.0 to 2.1)
0.18
(0.10 to 0.26)
6
(4 to 10)
180
(97 to 263)
Low
Solifenacin vs. placeboAdverse effects31,71352/361.7
( 1.2 to 2.4)
0.18
(0.09 to 0.27)
6
(4 to 12)
177
(85 to 267)
High
Solifenacin vs. placeboDiscontinuation due to adverse effects79,0805/41.3
(1.1 to 1.7)
0.01
(0.00 to 0.03)
78
(39 to 823)
13
(1 to 26)
High
Solifenacin vs. placeboDiscontinuation due to failure42,8122/11.0
(0.5 to 1.8)
0.00
(−0.01 to 0.01)
NSModerate
Tolterodine vs. placeboContinence43,40453/441.2
(1.1 to 1.4)
0.09
(0.04 to 0.13)
12
(8 to 25)
85
(40 to 129)
High
Tolterodine vs. placeboImproved UI76,11945/371.3
(1.1 to1.4)
0.10
(0.04 to 0.15)
10
(7 to 24)
96
(42 to 149)
High
Tolterodine vs. placeboAdverse effects124,16245/381.2
(1.1 to 1.3)
0.08
(0.05 to 0.12)
12
(8 to 21)
83
(47 to 120)
High
Tolterodine vs. placeboDiscontinuation due to adverse effects104,4664/31.0
(0.6 to 1.7)
0.01
(−0.01 to 0.03)
NSHigh
Tolterodine vs. placeboDiscontinuation due to failure54,0491/20.5
(0.2 to 0.9)
−0.01
(−0.01 to 0.00)
NSHigh
Trospium vs. placeboContinence42,67728/171.7
(1.5 to 2.0)
0.11
(0.08 to 0.14)
9
(7 to 12)
114
(83 to 144)
High
Trospium vs. placeboImproved UI21,17632/251.1
(0.6 to 2.0)
0.08
(−0.10 to 0.25)
NSLow
Trospium vs. placeboAdverse effects52,96741/291.4
(1.2 to 1.7)
0.12
(0.09 to 0.16)
8
(6 to 11)
123
(88 to 159)
Moderate
Trospium vs. placeboDiscontinuation due to adverse effects63,9366/41.5
(1.1 to 1.9)
0.02
(0.00 to 0.03)
56
(30 to 228)
18
(4 to 33)
High
Fesoterodine vs. tolterodineContinence23,31261/561.10
(1.04 to 1.16)
0.06
(0.02 to 0.09)
18
(11 to 48)
55
(21 to 88)
Low
Fesoterodine vs. tolterodineImproved UI34,42544/351.06
(1; 1.2)
0.03
(0; 0.06)
36
(17 to 1000)
28
(1 to 57)
↑/↑High
Fesoterodine vs. tolterodineDiscontinuation due to adverse effects44,4405/41.54
(1.21 to 1.97)
0.02
(0.01 to 0.03)
58
(33 to 206)
17
(5 to 31)
Moderate
Oxybutynin vs. tolterodineImproved UI394750/451.11
(0.94 to 1.31)
0.05
(−0.03 to 0.13)
NSModerate
Oxybutynin vs. tolterodineDiscontinuation due to adverse effects62,32313/61.9
(1.1 to 3.3)
0.07
(0.01 to 0.15)
14
(7 to 145)
72
(7 to 154)
High
Solifenacin vs. tolterodineDiscontinuation due to adverse effects32,7554/31.28
(0.86 to 1.91)
0.01
(0.00 to 0.03)
NSModerate
Trospium vs. oxybutyninDiscontinuation due to adverse effects22,0155/70.75
(0.52; 1.1)
0.00
(−0.03 to 0.05)
NSLow
Nonpharmacological treatments
Bladder training vs. no active treatmentImproved UI228361.4/19.23.22
(2.25 to 4.60)
0.43
(0.28 to 0.59)
2
(2 to 4)
430
(275 to 585)
Low
Continence service vs. no active treatmentContinence33,93929/201.6
(1.1 to 2.3)
0.30
(−0.01 to 0.60)
↑/NSModerate
Continence service vs. no active treatmentImproved UI24,03862.6/53.51.33
(1.06 to 1.68)
0.20
(−0.01 to 0.41)
↑/NSLow
Electrical stimulation vs. no active treatmentContinence742023/82.9
(1.6 to 5.2)
0.16
(0.06 to 0.26)
6
(4 to 16)
162
(64 to 259)
High
Electrical stimulation vs. no active treatmentImproved UI858231.7/15.12.01
(1.28 to 3.15)
0.16
(0.08 to 0.23)
6
(4 to 12)
156
(84 to 228)
High
Magnetic stimulation vs. no active treatmentImproved UI315346.8/21.22.30
(1.43 to 3.71)
0.27
(0.11 to 0.42)
4
(2 to 9)
265
(112 to 417)
Moderate
Magnetic stimulation vs. no active treatmentContinence317130.7/17.81.22
(0.78 to 1.88)
0.09
(−0.01 to 0.18)
NSModerate
Percutaneous electrical stimulation vs. no active treatmentImproved UI340540/201.9
(1.1 to 3.2)
0.31
(0.04 to 0.58)
3
(2 to 25)
308
(40 to 577)
Moderate
PFMT vs. no active treatmentContinence1095938/123.8
(2.1 to 6.8)
0.30
(0.19 to 0.41)
3
(2 to 5)
299
(188 to 410)
High
PFMT vs. no active treatmentImproved UI651056.9/14.75.44
(1.57 to 18.83)
0.41
(0.17 to 0.65)
2
(2 to 6)
412
(174 to 649)
High
PFMT with bladder training vs. no active treatmentContinence51,36921/123.8
(1.5 to 9.3)
0.17
(0.06 to 0.27)
6
(4 to 16)
166
(63 to 268)
High
PFMT with bladder training vs. no active treatmentImproved UI41,17153.3/22.54.13
(1.58 to 10.78)
0.39
(0.17 to 0.60)
3
(2 to 6)
387
(171 to 603)
High
PFMT with biofeedback vs. no active treatmentContinence218542/211.2
(2.2 to 56.4)
0.49
(−0.10 to 1.08)
↑/NSLow
PFMT with biofeedback vs. no active treatmentImproved UI438360.1/18.63.93
(1.00 to 15.49)
0.39
(0.17 to 0.61)
3
(2 to 6)
390
(170 to 610)
High
Weight Loss vs. no active treatmentImproved UI238642.8/20.82.17
(1.26 to 3.76)
0.27
(0.06 to 0.50)
4
(2 to 18)
273
(57 to 490)
Moderate
PFMT + bladder training vs. bladder trainingContinence227121/211
(0.4 to 2. 8)
0.001
(−0.2 to 0.2)
NSHigh
PFMT vs. electrical stimulationContinence39924/290.85
(0.45 to 1.61)
−0.04
(−0.20 to 0.11)
NSModerate
PFMT vs. electrical stimulationImproved UI413631/450.97
(0.62 to 1.51)
−0.01
(−0.17 to 0.16)
NSModerate
PFMT vs. vaginal coneContinence332022/270.78
(0.58 to 1.06)
−0.11
(−0.26 to 0.04)
NSModerate
PFMT vs. vaginal coneImproved UI444041/411.02
(0.91 to 1.14)
0.01
(−0.08 to 0.09)
NSModerate
PFMT with biofeedback vs. PFMTContinence654230/251.27
(0.88 to 1.85)
0.08
(−0.03 to 0.19)
NSHigh
Supervised PFMT vs. self-PFMTContinence430035/221.92
(0.87 to 4.23)
0.20
(−0.03 to 0.43)
NSHigh
Supervised PFMT vs. self-PFMTImproved UI428350/331.51
(0.85 to 2.67)
0.14
(−0.05 to 0.32)
NSModerate

Note: CI=confidence interval; PFMT=pelvic floor muscle training; NS=not significant; RCT=randomized controlled trial; UI=urinary incontinence; ↑=effect of active drug is greater than control; ↓=effect of active drug is lower than control.

*

Risk differences for drug adverse effects were calculated using arcsine transformation

From: Executive Summary

Cover of Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness
Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness [Internet].
Comparative Effectiveness Reviews, No. 36.
Shamliyan T, Wyman J, Kane RL.

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