Pelvic floor rehabilitation management in females with stress urinary incontinence: a summary of best-evidence strategies

BACKGROUND: The current evidence on pelvic floor rehabilitation management for females with stress urinary incontinence (SUI) is diverse and complex, and standardized pelvic floor rehabilitation protocols are lacking. The study aimed to retrieve and summarize the evidence related to pelvic floor rehabilitation management in females who experience SUI and provide guidance for healthcare workers. METHODS: Following the 6S evidence resource pyramid model, two researchers searched the computer decision support system, guidelines networks, urological professional society websites, obstetrics and gynecology professional society websites, and related databases from top to bottom and collected the best clinical practice information books, clinical decision-making, recommendation practice, evidence summaries, guidelines, systematic reviews, and expert consensuses on the management of pelvic floor rehabilitation in females suffering SUI. The searches were carried out from database inception to September 2022. Literature quality was independently assessed by two researchers, and evidence was then obtained and summarized from eligible studies. RESULTS: Forty-eight studies were eligible to be included, comprising 1 best clinical practice information book, 4 clinical decision-making, 3 recommended practices, 10 evidence summaries, 8 guidelines, 18 systematic reviews, and 4 expert consensus studies. Best-evidence strategies summarized the evidence for pelvic floor rehabilitation management in females with SUI, which included a total of 51 recommendations in 5 aspects: screening and assessment, lifestyle management, pelvic floor muscle training (PFMT), follow-up, and health education. CONCLUSION: The review summarized 51 best-evidence strategies for pelvic floor rehabilitation management in females with SUI. To ensure clinical efficacy and improve nursing quality, these strategies should be integrated into structured, multidisciplinary clinical pathways, carefully tailored to specific patient contexts and local healthcare resources.