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Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women: Shortened version of a Cochrane systematic review§


  • Mickey Karram led the peer-review process as the Associate Editor responsible for the paper.

  • This paper is based on a Cochrane Review published in The Cochrane Library 2011, Issue 7 (see for more information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback. The Cochrane Library should be consulted for the most recent version of the review. If you wish to comment on this or other Cochrane Reviews, please use the Cochrane Library Feedback System. The results of a Cochrane Review can be interpreted differently, depending on people's perspectives and circumstances. Please consider the conclusions presented carefully. They are opinions of the review authors, and are not necessarily shared by The Cochrane Collaboration.

  • §

    Conflict of interest: none.



Feedback and biofeedback (BF) are common adjuncts to pelvic floor muscle training (PFMT) for women with stress, urgency, and mixed urinary incontinence (UI). An up to date systematic review of adjunctive feedback or BF was needed to guide practice and further research.


To determine whether feedback or BF add benefit to PFMT for women with UI.


The Cochrane Incontinence Group Specialised Trials Register was searched (May 2010) for randomised or quasi-randomized trials in women with stress, urgency or mixed UI regardless of cause, which compared PFMT versus PFMT augmented with feedback or BF. Two reviewers independently undertook eligibility screening, risk of bias assessment and data extraction. Analysis was in accordance with the Cochrane Handbook for Systematic Reviews of Intervention (version 5.0.2).


Twenty-four trials were included, and many were at moderate to high risk of bias. Women who received BF were less likely to report they were not improved (RR 0.75, 95% CI: 0.66–0.86), although there was no statistically significant difference for cure (RR 0.92, 95% CI: 0.81–1.05) and marginal statistical significance for leakage episodes (mean difference: −0.12 leaks/day, 95% CI: −0.22 to −0.01). It is possible the results are confounded because women in the BF group commonly had more contact with the health professional than those in the PFMT only arm.


BF may add benefit to PFMT but the observed effect could well be related to another variable, such as the amount of health professional contact rather than the BF per se. Neurourol. Urodynam. 32: 325–329, 2013. © 2012 Wiley Periodicals, Inc.