Interventions for treating urinary incontinence in older women: a network meta-analysis

Due to the limited number of trials and generally small sample sizes, the precision of estimates regarding treatment benefits and harms was low. We successfully conducted an NMA, but there was insufficient evidence to support a robust overall analysis. To establish a connected treatment network, we excluded surgical intervention studies. As a result, the analysis focused on conservative and pharmacological treatment comparisons. For the outcome of 'cure', evidence rated as very low to low certainty suggests that physical therapies combined with complementary therapies may be the most effective option, followed by physical therapies alone or combined with education. For 'cure or improvement', both physical therapies (with or without education) and β3-adrenergic agonists showed potential benefits. SAEs were absent for conservative interventions, whereas most of the pharmacological treatment studies reported some. However, there was insufficient evidence to determine whether any treatment reduced the likelihood of SAEs. Overall, the number and quality of studies were insufficient to draw firm conclusions about the most effective treatment for urinary incontinence in older women. To strengthen the evidence base, larger, high-quality trials with clearly defined interventions and consistently reported outcomes are needed.