The effectiveness of magnetic stimulation for patients with pelvic floor dysfunction: A systematic review and meta-analysis

AimsMethodsTo evaluate the value of magnetic stimulation (MS) in patients with pelvic floor dysfunction (PFD). The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement was followed. We searched five databases for articles published until November 2017. Included studies investigated the effects of MS on PFD. Meta-analysis of RCTs was performed using a random effects model, and narrative analysis was undertaken where meta-analysis was not possible. ResultsConclusionsA total of 20 studies including 1019 patients were eligible for inclusion whose level of evidence for the included studies was low. Meta-analysis of four trials comparing MS with sham intervention showed that MS was not associated with significant improvement in ICIQ-SF score (-0.52, 95%CI -1.05, 0.01; P=0.06, I-2=16%), QOL score (-0.27, 95%CI -0.57, 0.04; P=0.09, I-2=0%), number of leakages (-0.16, 95%CI -0.62, 0.29; P=0.48, I-2=52%), and pad test (-1.36, 95%CI -2.64, -0.08; P=0.04, I-2=94%). Narrative review showed that there were no convincing evidences that MS was effective for chronic pelvic floor pain, detrusor overactivity, overactive bladder, and the included RCTs had controversial results. MS may have some benefits for nocturnal enuresis and erectile dysfunction according to the trials. There is no convinced evidence to support the benefits of using MS in the management of PFD. The applicability of MS in the treatment of PFD remains uncertain, so larger, well-designed trials with longer follow-up periods adopted relevant and comparable outcomes are needed to be further explored to provide a definitive conclusion.