Effectiveness of pessary and pelvic floor physiotherapy alone and in combination for management of stress and mixed urinary incontinence: a literature review
Bibliographic record
Abstract
Stress urinary incontinence (SUI) affects 29–75% of women and can have a significant impact on quality of life. Pessaries are low-cost interventions that have been used since the 5 th century BC. Pessaries can be used to conservatively manage SUI alone or in combination with other evidence-based conservative treatments, such as pelvic floor physiotherapy. Unfortunately, pessaries have been underutilized and the value of pessaries in the treatment of SUI remains uncertain. Pessary is an effective short-term management option for SUI. Improvement in SUI was noted in 36–66% of patients. Combination of pessary and behavioural therapy is more effective than pessary alone. Behavioural therapy includes pelvic floor physiotherapy and instructions for use of pelvic floor muscles to prevent SUI. For long-term pessary use, results are conflicting. The current evidence is limited by considerable discontinuation and dropout rates. There is a gap in knowledge regarding the effects of long-term pessary and pelvic floor physiotherapy use alone and in combination for treatment of SUI with more frequent clinician contact. Future research would guide clinicians in the value of pessary use and assist in managing patient expectations.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".