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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 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 source (direct Gemma or distilled Codex), 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".