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Psychological therapy for women with pelvic floor dysfunction
Pelvic floor dysfunction: prevention and non-surgical management
Evidence review O
NICE Guideline, No. 210
Authors
National Guideline Alliance (UK).London: National Institute for Health and Care Excellence (NICE); 2021 Dec.
ISBN-13: 978-1-4731-4364-7
Copyright © NICE 2021.
Psychological therapy for pelvic floor dysfunction
Review question
What is the effectiveness of psychological interventions for women with symptoms associated with pelvic floor dysfunction?
Introduction
Women who have pelvic floor dysfunction can also have high levels of depression and anxiety, and experience low mood, and emotional distress, impacting on their quality of life. There is evidence that the presence of these psychological conditions reduces the likelihood that women will attend for PFMT, and, if they do attend, the presence of these disorders will reduce the outcomes of that intervention. Given this, it seemed to the committee important to explore the extent to which psychological interventions would improve pelvic floor symptoms.
Summary of the protocol
See Table 1 for a summary of the Population, Intervention, Comparison and Outcome (PICO) characteristics of this review.
For further details, see the review protocol in appendix A.
Declarations of interest were recorded according to NICE’s 2019 conflicts of interest policy.
Methods and process
This evidence review was developed using the methods and process described in Developing NICE guidelines: the manual. Methods specific to this review question are described in the review protocol in appendix A and the methods document (supplementary document 1).
Declarations of interest were recorded according to NICE’s conflicts of interest policy.
Clinical evidence
Included studies
Seven publications were included for this review, (Carty 2018, Felsted 2019, Komesu 2011, Osborne 2016, Ter kuile 2013, van Lankveld 2006 and Zarski 2017), all were randomised controlled trials (RCTs).
The included studies are summarised in Table 3 (studies specifically referring to pelvic floor dysfunction) and Table 2 (studies specifically addressing vaginismus)
One study compared a life stress emotional awareness and expression interview to control in women with chronic urogenital pain (Carty 2018).
One feasibility study compared a mindfulness based stress reduction program to a health enhancement program in women with urge urinary incontinence (UUI) (Felsted 2019).
One study compared hypnotherapy to standard care (behavioural therapy) in women with OAB (Komesu 2011)
One study compared having a motivational interview prior to pelvic floor muscle training (PFMT) to standard care in women with PFD (Osborne 2016)
Three of the studies investigated the effects of psychological therapy on vaginismus (Ter Kuile 2103, van Lankveld 2006, Zarski 2017).
No evidence was found for other symptoms associated with PFD (faecal incontinence, emptying disorders of the bowel or pelvic organ prolapse)
See the literature search strategy in appendix B and study selection flow chart in appendix C.
Excluded studies
Studies not included in this review are listed, and reasons for their exclusion are provided in appendix K.
Summary of studies included in the evidence review
Summaries of the studies that were included in this review are presented in Table 3 and Table 2
See the full evidence tables in appendix D. No meta-analysis was conducted (and so there are no forest plots in appendix E).
Quality assessment of studies included in the evidence review
See the evidence profiles in appendix F.
Economic evidence
Included studies
A single economic search was undertaken for all topics included in the scope of this guideline but no economic studies were identified which were applicable to this review question. See the literature search strategy in appendix B and economic study selection flow chart in appendix G.
Excluded studies
Economic studies not included in this review are listed, and reasons for their exclusion are provided in appendix K.
Economic model
No economic modelling was undertaken for this review because the committee agreed that other topics were higher priorities for economic evaluation because it was unlikely that recommendations would have a significant resource impact.
Brief summary of the evidence
Psychological therapy for vaginismus
- Very low to low quality evidence showed that exposure therapy as compared to wait list control showed improved outcomes for vaginismus, vaginal penetration, pain, fear of coitus and overall sexual functioning.
- Very low to low quality evidence showed group CBT and bibliotherapy both improved penetration as compared to waitlist control; however, the bibliotherapy appeared more effective than group CBT.
- Very low quality evidence showed a benefit of an internet based self-help program in terms of overall sexual functioning but showed no differences compared to control for penetration or fear of coitus.
Emotional expression and awareness interview versus treatment as usual of women with chronic urogenital pain
- Very low quality evidence showed a benefit for an emotional expression and awareness interview for pain severity and pelvic floor distress scores, but showed no effect on anxiety or depression.
Mindful based stress reduction versus embedded health programme for women with urge urinary incontinence
- Low quality evidence from a feasibility study showed more women no difference in retention in the intervention when receiving mindfulness based stress reduction as compared to an embedded health program.
Hypnotherapy versus behavioural therapy for women with overactive bladder
- Very low quality evidence showed no difference in outcomes between hypnotherapy and behavioural therapy.
Motivational interview versus pelvic floor muscle training alone for PFD
- Low quality evidence suggested a motivational interview before PFMT sessions improves the number of classes attended.
The committee’s discussion of the evidence
Interpreting the evidence
The outcomes that matter most
The committee agreed that improvement in symptoms associated with pelvic floor dysfunction were the most critical outcomes as this is a review on management of symptoms, and therefore the intervention should improve these. The committee agreed that important outcomes were health related quality of life and change in psychological factors (anxiety/depression) as these should be improved by a successful psychological intervention; additionally, and these are important outcomes as PFD often has a large impact on a woman’s psychological state. Other important outcomes included adherence and satisfaction of the intervention, these outcomes likely influence the effect size of the outcome and should therefore be considered.
The quality of the evidence
The quality of the evidence for this review was assessed using GRADE and ranged from very low to low quality. All studies were downgraded due to risk of bias in the measurement of outcomes, as these were generally self-reported and as such open to influence from bias relating to assumptions about the effect of treatment. Additionally, the participants could not be blinded to the interventions due to the nature of treatment. Some outcomes were also downgraded due to imprecision in the data, which may be related to small study size.
No evidence was found for acceptance and commitment therapy, dialectical behaviour therapy, guided self-help therapy, pure self-help or combined pharmacological and psychological treatment.
Benefits and harms
Overall, the evidence presented was limited and varied in quality. Due to the uncertainty in the evidence the committee could not use it to support their recommendations. The committee noted based on their experience that the symptoms of pelvic floor dysfunction can cause embarrassment and that women can feel stigmatised. They therefore decided that it is important to ask the woman about their psychological wellbeing and whether this is affected negatively by their symptoms. The committee discussed that this would allow women to talk about their feelings and help explore whether further psychological help may be need.
Evidence suggested that psychological interventions improved attendance and adherence to therapies such as pelvic floor muscle training. The committee agreed that in their clinical experience, adherence is important in the management of the symptoms associated with pelvic floor dysfunction. However, as the evidence did not address whether psychological interventions directly improve symptoms of pelvic floor dysfunction, the committee discussed whether a research recommendation is needed. They were conscious that the studies identified did not evaluate if psychological interventions improved the psychological distress experienced by the women. Due to this gap in research, the committee made a research recommendation to investigate this further.
Cost effectiveness and resource use
Although the clinical evidence was generally limited the committee noted that some evidence suggested that psychological therapies might improve adherence to treatment and therefore could potentially be cost-effective depending on the size of the effect. However, as there was no direct evidence that these psychological interventions improved the symptoms of pelvic floor dysfunction the committee limited themselves to a research recommendation. They also cross referenced the NICE guidelines on antenatal and postnatal mental health and depression in adults with a chronic physical health problem for cost-effective recommendations that could be related to women’s pelvic floor dysfunction symptoms.
Other factors the committee took into account
They also agreed to refer to the NICE guideline on antenatal and postnatal mental health as this provides relevant advice on psychological wellbeing before and after giving birth and the NICE Depression in adults with a chronic physical health problem: recognition and management (2009) guideline because pelvic floor dysfunction can become a chronic condition which can lead to depression.
Recommendations supported by this evidence review
This evidence review supports recommendations 1.6.28, 1.6.29 and a research recommendation on psychological interventions in the NICE guideline.
References
Carty 2018
Carty, J. N., Ziadni, M. S., Holmes, H. J., Tomakowsky, J., Peters, K., Schubiner, H., Lumley, M. A., The Effects of a Life Stress Emotional Awareness and Expression Interview for Women with Chronic Urogenital Pain: A Randomized Controlled Trial, Pain medicine, 24, 2018 [PMC free article: PMC6611525] [PubMed: 30252113]Felsted 2019
Felsted, Katarina Friberg, Supiano, Katherine P., Mindfulness-Based Stress Reduction Versus a Health Enhancement Program in the Treatment of Urge Urinary Incontinence in Older Adult Women: A Randomized Controlled Feasibility Study, Research in Gerontological Nursing, 12, 285–297, 2019 [PubMed: 31283830]Komesu 2011
Komesu, Y. M.; Sapien R. E.; Rogers, r. G.; Ketai, L.H.; Hypnotherapy for treatment of overactive bladder: a randomised controlled trial pilot study. Female Pelvic Medicine & Reconstructive Surgery 17, 308–313 [PMC free article: PMC4575591] [PubMed: 22453228]Osborne 2016
Osborne, L. A., Whittall, C. M., Edwards, D. J., Emanuel, R., Emery, S., Reed, P., Randomized control trial of a values-based motivational interview support to promote attendance at pelvic floor muscle training physiotherapy treatment, Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 38–46, 2016TerKuile 2013
Ter Kuile, M. M., Melles, R., de Groot, H. E., Tuijnman-Raasveld, C. C., van Lankveld, Jjdm, Therapist-aided exposure for women with lifelong vaginismus: a randomized waiting-list control trial of efficacy, Journal of Consulting & Clinical PsychologyJ Consult Clin Psychol, 81, 1127–1136, 2013 [PubMed: 24060195]Van Lankveld 2006
van Lankveld, J. J., ter Kuile, M. M., de Groot, H. E., Melles, R., Nefs, J., Zandbergen, M., Cognitive-behavioral therapy for women with lifelong vaginismus: a randomized waiting-list controlled trial of efficacy, Journal of Consulting & Clinical PsychologyJ Consult Clin Psychol, 74, 168–78, 2006 [PubMed: 16551154]Zarski 2017
Zarski, A. C., Berking, M., Fackiner, C., Rosenau, C., Ebert, D. D., Internet-Based Guided Self-Help for Vaginal Penetration Difficulties: Results of a Randomized Controlled Pilot Trial, Journal of sexual medicine, 14, 238–254, 2017 [PubMed: 28161080]
Appendices
Appendix A. Review protocol
Appendix B. Literature search strategies
Appendix C. Clinical evidence study selection
Appendix D. Clinical evidence tables
Appendix E. Forest plots
Forest plots for review question: What is the effectiveness of psychological interventions for women with symptoms associated with pelvic floor dysfunction?
No meta-analysis was conducted for this review question and so there are no forest plots.
Appendix F. GRADE tables
Appendix G. Economic evidence study selection
Appendix H. Economic evidence tables
Economic evidence tables for review question: What is the effectiveness of psychological interventions for women with symptoms associated with pelvic floor dysfunction?
No evidence was identified which was applicable to this review question.
Appendix I. Economic evidence profiles
Economic evidence profiles for review question: What is the effectiveness of psychological interventions for women with symptoms associated with pelvic floor dysfunction?
No economic evidence was identified which was applicable to this review question.
Appendix J. Economic analysis
Economic evidence analysis for review question: What is the effectiveness of psychological interventions for women with symptoms associated with pelvic floor dysfunction?
No economic analysis was conducted for this review question.
Appendix K. Excluded studies
Excluded studies for review question: What is the effectiveness of psychological interventions for women with symptoms associated with pelvic floor dysfunction?
Clinical studies
Table 15Excluded studies and reasons for their exclusion
| Study | Reason for Exclusion |
|---|---|
| Mindfulness and sex therapy, Journal of Sexual Medicine, Conference: 22nd Congress of theWorld Association for Sexual Health, WAS 2015. Singapore. 12, 333, 2015 | Conference abstract |
| Adam, F., De Sutter, P., Day, J., Grimm, E., A Randomized Study Comparing Video-Based Mindfulness-Based Cognitive Therapy With Video-Based Traditional Cognitive Behavioral Therapy in a Sample of Women Struggling to Achieve Orgasm, Journal of Sexual Medicine, 06, 06, 2019 [PubMed: 31818723] | Population does not meet the inclusion criteria; no mention of sexual dysfunction caused by pelvic floor dysfunction |
| Albers-Heitner, P. C., Lagro-Janssen, T. A., Joore, M. M., Berghmans, B. L., Nieman, F. F., Venema, P. P., Severens, J. J., Winkens, R. R., Effectiveness of involving a nurse specialist for patients with urinary incontinence in primary care: results of a pragmatic multicentre randomised controlled trial, International Journal of Clinical Practice, 65, 705–712, 2011 [PubMed: 21564445] | Intervention does not meet the inclusion criteria, multi-component but no psychological aspect. |
| Anonymous,, Erratum: Comparison of 2 transvaginal surgical approaches and perioperative behavioral therapy for apical vaginal prolapse: The OPTIMAL randomized trial (JAMA (2014) 311:10 (1023–1034) 10.1001/jama.2014.1719), JAMA - Journal of the American Medical Association, 313, 2287, 2015 [PMC free article: PMC4083455] [PubMed: 24618964] | Erratum |
| Ayeleke, R. O., Hay-Smith, E. J. C., Omar, M. I., Pelvic floor muscle training added to another active treatment versus the same active treatment alone for urinary incontinence in women, Cochrane Database of Systematic Reviews, 2015 [PMC free article: PMC7081747] [PubMed: 26526663] | Intervention does not meet the inclusion criteria, no psychological aspect. Maybe suitable for 8.1 |
| Ayeleke, R., Hay-Smith, J., Omar, M., Pelvic floor muscle training added to another active treatment versus the same active treatment alone for urinary incontinence in women: Cochrane systematic review, International Urogynecology Journal and Pelvic Floor Dysfunction, 1), S177–S178, 2014 | Conference abstract |
| Baker, J., Costa, D., Guarino, J. M., Nygaard, I., Comparison of mindfulness-based stress reduction versus yoga on urinary urge incontinence: a randomized pilot study. with 6-month and 1-year follow-up visits, Female Pelvic Medicine & Reconstructive Surgery, 20, 141–6, 2014 [PubMed: 24763155] | No relevant outcome reported |
| Baker, J., Nygaard, I., Costa, D., Comparison of mindfulness based stress reduction (MBSR) vs yoga on urgency incontinence: A randomized pilot study, Female Pelvic Medicine and Reconstructive Surgery, 19, S76, 2013 [PubMed: 24763155] | Conference abstract |
| Balk, E. M., Adam, G. P., Corsi, K., Mogul, A., Trikalinos, T. A., Jeppson, P. C., Adverse Events Associated with Nonsurgical Treatments for Urinary Incontinence in Women: a Systematic Review, Journal of General Internal Medicine, 34, 1615–1625, 2019 [PMC free article: PMC6667523] [PubMed: 31062225] | Systematic review, references checked - interventions included not relevant |
| Balk, E. M., Rofeberg, V. N., Adam, G. P., Kimmel, H. J., Trikalinos, T. A., Jeppson, P. C., Pharmacologic and Nonpharmacologic Treatments for Urinary Incontinence in Women: A Systematic Review and Network Meta-analysis of Clinical Outcomes, Annals of Internal Medicine, 170, 465–479, 2019 [PubMed: 30884526] | Systematic review, references checked - interventions included not relevant |
| Balk, E., Adam, G. P., Kimmel, H., Rofeberg, V., Saeed, I., Jeppson, P., Trikalinos, T., Nonsurgical Treatments for Urinary Incontinence in Women: A Systematic Review Update [Internet]., Agency for Healthcare Research and Quality (US), 08, 2018 [PMC free article: PMC534625] [PubMed: 30516945] | Systematic review, references checked - interventions included not relevant |
| Barber, M. D., Visco, A. G., Wyman, J. F., Fantl, J. A., Bump, R. C., Continence Program for Women Research, Group, Sexual function in women with urinary incontinence and pelvic organ prolapse, Obstetrics & Gynecology, 99, 281–9, 2002 [PubMed: 11814510] | Intervention does not meet the inclusion criteria; drug and behavioural therapy intervention, no psychological aspect |
| Bernard, S., Boucher, S., McLean, L., Moffet, H., Mobile technologies for the conservative self-management of urinary incontinence: a systematic scoping review, International Urogynecology Journal., 2019 [PubMed: 31267139] | Systematic review, references checked - interventions included not relevant |
| Borello-France, D., Burgio, K. L., Goode, P. S., Markland, A. D., Kenton, K., Balasubramanyam, A., Stoddard, A. M., Urinary Incontinence Treatment, Network, Adherence to behavioral interventions for urge incontinence when combined with drug therapy: adherence rates, barriers, and predictors, Physical Therapy, 90, 1493–505, 2010 [PMC free article: PMC2949583] [PubMed: 20671098] | Intervention does not meet the inclusion criteria. Maybe suitable for 8.1 or 11.1 |
| Borello-France, D., Burgio, K. L., Goode, P. S., Ye, W., Weidner, A. C., Lukacz, E. S., Jelovsek, J. E., Bradley, C. S., Schaffer, J., Hsu, Y., Kenton, K., Spino, C., Pelvic Floor Disorders, Network, Adherence to behavioral interventions for stress incontinence: rates, barriers, and predictors, Physical Therapy, 93, 757–73, 2013 [PMC free article: PMC3664038] [PubMed: 23431210] | Intervention does not meet the inclusion criteria. |
| Borrie, M. J., Bawden, M., Speechley, M., Kloseck, M., Interventions led by nurse continence advisers in the management of urinary incontinence: A randomized controlled trial, Cmaj, 166, 1267–1273, 2002 [PMC free article: PMC111077] [PubMed: 12041843] | Population does not meet the inclusion criteria, both men and women included in the study, no separate data on women |
| Brady, M., Fitzgerald, C. M., Adams, W., Brubaker, L., Mueller, E. R., Brincat, C., Patient preparedness for pelvic floor physical therapy: Standard counseling vs video, Female Pelvic Medicine and Reconstructive Surgery, 23 (5 Supplement 1), S13–S14, 2017 | Conference abstract |
| Braun, E. J., Wise, M. E., Jansen, S. M., Myers, S., Sampene, E., Li, Z., Moberg, D. P., Rogers, R. G., Mahoney, J., Brown, H. W., Mind over matter; Healthy bowels, healthy bladder: an individually randomized group treatment trial, Female Pelvic Medicine & Reconstructive Surgery, 24, S51–S52, 2018 | Intervention does not meet the inclusion criteria, no psychological aspect. |
| Braun, E. J., Wise, M. E., Jansen, S., Myers, S., Sampene, E., Li, Z., Moberg, D. P., Rogers, R. G., Mahoney, J. E., Brown, H. W., Best in category prize prevention and public health: mind over matter; healthy bowels, healthy bladder: an individually randomized group treatment trial, Neurourology and Urodynamics, 37, S319–S320, 2018 | Conference abstract |
| Brotto, L. A., Basson, R., Group mindfulness-based therapy significantly improves sexual desire in women, Behaviour Research and Therapy, 57, 43–54, 2014 [PubMed: 24814472] | Doesn’t specify that sexual dysfunction is associated with pelvic floor dysfunction |
| Burgio, K. L., Influence of behavior modification on overactive bladder, Urology, 60, 72–6; discussion 77, 2002 [PubMed: 12493360] | Interventions not psychological |
| Burgio, K. L., Goode, P. S., Locher, J. L., Umlauf, M. G., Roth, D. L., Richter, H. E., Varner, R. E., Lloyd, L. K., Behavioral training with and without biofeedback in the treatment of urge incontinence in older women: A randomized controlled trial, Journal of the American Medical Association, 288, 2293–2299, 2002 [PubMed: 12425706] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Burgio, K. L., Kraus, S. R., Borello-France, D., Chai, T. C., Kenton, K., Goode, P. S., Xu, Y., Kusek, J. W., Urinary Incontinence Treatment, Network, The effects of drug and behavior therapy on urgency and voiding frequency, International Urogynecology Journal, 21, 711–9, 2010 [PMC free article: PMC3119359] [PubMed: 20143047] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Burgio, K. L., Kraus, S. R., Menefee, S., Borello-France, D., Corton, M., Johnson, H. W., Mallett, V., Norton, P., FitzGerald, M. P., Dandreo, K. J., Richter, H. E., Rozanski, T., Albo, M., Zyczynski, H. M., Lemack, G. E., Chai, T. C., Khandwala, S., Baker, J., Brubaker, L., Stoddard, A. M., Goode, P. S., Nielsen-Omeis, B., Nager, C. W., Kenton, K., Tennstedt, S. L., Kusek, J. W., Chang, T. D., Nyberg, L. M., Steers, W., Urinary Incontinence Treatment, Network, Behavioral therapy to enable women with urge incontinence to discontinue drug treatment: a randomized trial, Annals of Internal Medicine, 149, 161–9, 2008 [PMC free article: PMC3201984] [PubMed: 18678843] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Burgio, K. L., Locher, J. L., Goode, P. S., Combined behavioral and drug therapy for urge incontinence in older women, Journal of the American Geriatrics Society, 48, 370–4, 2000 [PubMed: 10798461] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Burgio, K. L., Locher, J. L., Goode, P. S., Hardin, J. M., McDowell, B. J., Dombrowski, M., Candib, D., Behavioral vs drug treatment for urge urinary incontinence in older women: a randomized controlled trial, JAMA, 280, 1995–2000, 1998 [PubMed: 9863850] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Burgio, K. L., Locher, J. L., Roth, D. L., Goode, P. S., Psychological improvements associated with behavioral and drug treatment of urge incontinence in older women, Journals of Gerontology - Series B Psychological Sciences and Social Sciences, 56, P46–P51, 2001 [PubMed: 11192337] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Burton, J. R., Pearce, K. L., Burgio, K. L., Engel, B. T., Whitehead, W. E., Behavioral training for urinary incontinence in elderly ambulatory patients, Journal of the American Geriatrics Society, 36, 693–8, 1988 [PubMed: 3403874] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Byrne, C. M., Solomon, M. J., Rex, J., Young, J. M., Heggie, D., Merlino, C., Telephone vs. face-to-face biofeedback for fecal incontinence: Comparison of two techniques in 239 patients, Diseases of the Colon and Rectum, 48, 2281–2288, 2005 [PubMed: 16258709] | Population includes men and cannot separate out data on women |
| Carrión Pérez, F., Rodríguez Moreno, M. S., Carnerero Córdoba, L., Romero Garrido, M. C., Quintana Tirado, L., García Montes, I., Telerehabilitation to treat stress urinary incontinence. Pilot study, Medicina clinica, 144, 445–448, 2015 [PubMed: 25087210] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Carty, J., Lumley, M., Holmes, H., Tomakowsky, J., Schubiner, H., Dove-Medows, E., Peters, K., The effects of a stress and emotion interview for women with urogenital pain: A randomized trial, Journal of Pain, 1), S103, 2016 | Conference abstract |
| Chelvanayagam, S., Stern, J., Using therapeutic groups to support women with faecal incontinence, British Journal of Nursing, 16, 214–8, 2007 [PubMed: 17363851] | Outcome data does not meet the inclusion criteria |
| Cichowski, S. B., Dunivan, G. C., Rogers, R. G., Murrietta, A. M., Komesu, Y. M., Standard compared with mnemonic counseling for fecal incontinence: a randomized controlled trial, Obstetrics & Gynecology, 125, 1063–70, 2015 [PMC free article: PMC4418023] [PubMed: 25932833] | Conference abstract |
| Cichowski, S. B., Dunivan, G., Komesu, Y., Rogers, R. G., Standard vs mnemonic counseling for fecal incontinence: A randomized controlled trial, International Urogynecology Journal and Pelvic Floor Dysfunction, 1), S12–S13, 2014 | Conference abstract |
| Cook, T., Group treatment of female urinary incontinence: Literature review, Physiotherapy, 87, 226–234, 2001 | Not a systematic review. RCTs checked |
| Cornelius, C., Monsour, M., Noursalehi, M., PeriCoach clinical study and real-world data insights, Female Pelvic Medicine and Reconstructive Surgery, 25 (5 Supplement 1), S287, 2019 | Conference abstract |
| Demain, S., Smith, J. F., Hiller, L., Dziedzic, K., Comparison of group and individual physiotherapy for female urinary incontinence in primary care, Physiotherapy, 87, 235–242, 2001 | Intervention does not meet the inclusion criteria |
| Diokno, A. C., Newman, D. K., Low, L. K., Griebling, T. L., Maddens, M. E., Goode, P. S., Raghunathan, T. E., Subak, L. L., Sampselle, C. M., Boura, J. A., Robinson, A. E., McIntyre, D., Burgio, K. L., Effect of Group-Administered Behavioral Treatment on Urinary Incontinence in Older Women: A Randomized Clinical Trial, JAMA Internal Medicine, 178, 1333–1341, 2018 [PMC free article: PMC6233747] [PubMed: 30193294] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Diokno, A. C., Ocampo, M. S., Jr., Ibrahim, I. A., Karl, C. R., Lajiness, M. J., Hall, S. A., Group session teaching of behavioral modification program (BMP) for urinary incontinence: a randomized controlled trial among incontinent women, International Urology & Nephrology, 42, 375–81, 2010 [PubMed: 19701691] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Diokno, A. C., Sampselle, C. M., Herzog, A. R., Raghunathan, T. E., Hines, S., Messer, K., Karl, C., Leite, M. C., Prevention of urinary incontinence by behavioral modification program: a randomized, controlled trial among older women in the community, Journal of Urology, 171, 1165–71, 2004 [PubMed: 14767293] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Dougherty, M. C., Dwyer, J. W., Pendergast, J. F., Boyington, A. R., Tomlinson, B. U., Coward, R. T., Duncan, R. P., Vogel, B., Rooks, L. G., A randomized trial of behavioral management for continence with older rural women, Research in nursing & health, 25, 3–13, 2002 [PubMed: 11807915] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Dowd, T., Kolcaba, K., Steiner, R., Using cognitive strategies to enhance bladder control and comfort, Holistic Nursing Practice, 14, 91–103, 2000 [PubMed: 12119974] | Population includes men and cannot separate out the data on women |
| Due, U., Brostrom, S., Lose, G., Lifestyle advice with or without pelvic floor muscle training for pelvic organ prolapse: a randomized controlled trial, International Urogynecology Journal, 27, 555–63, 2016 [PubMed: 26439114] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Dufour, S., Fedorkow, D., Fang, Q., The use of mobile health technology to support post-partum pelvic health: A randomized mixed methods pilot study, Neurourology and Urodynamics, 37 (Supplement 5), S70–S71, 2018 | Conference abstract |
| Dufour, S., Fedorkow, D., Kun, J., Deng, S. X., Fang, Q., Exploring the impact of a mobile health solution for postpartum pelvic floor muscle training: Pilot randomized controlled feasibility study, Journal of Medical Internet Research, 21 (7) (no pagination), 2019 [PMC free article: PMC6657451] [PubMed: 31298221] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Dyer, K. Y., Xu, Y., Brubaker, L., Nygaard, I., Markland, A., Rahn, D., Chai, T. C., Stoddard, A., Lukacz, E., Urinary Incontinence Treatment, Network, Minimum important difference for validated instruments in women with urge incontinence, Neurourology & Urodynamics, 30, 1319–24, 2011 [PMC free article: PMC5373473] [PubMed: 21563210] | Intervention does not meet the inclusion criterial; is not a psychological therapy |
| Elliott, V., De Bruin, E. D., Dumoulin, C., Virtual reality as a treatment approach for older women with mixed urinary incontinence: A feasibility study, Neurourology and Urodynamics, 31 (6), 940–941, 2012 [PubMed: 24415577] | Conference abstract |
| Farnam, F., Janghorbani, M., Raisi, F., Merghati-Khoei, E., Compare the effectiveness of PLISSIT and sexual health models on women’s sexual problems in Tehran, Iran: A randomized controlled trial, Journal of Sexual Medicine, 11, 2679–2689, 2014 [PubMed: 25091932] | Doesn’t specify that sexual dysfunction was associated with pelvic floor dysfunction |
| Felsted, K. F., Supiano, K. P., Mindfulness-Based Stress Reduction Versus a Health Enhancement Program in the Treatment of Urge Urinary Incontinence in Older Adult Women: A Randomized Controlled Feasibility Study, Research in Gerontological Nursing, 12, 285–297, 2019 [PubMed: 31283830] | Outcome data does not meet the inclusion criteria |
| Fera, P., Lelis, M. A., Glashan, R. Q., Pereira, S. G., Bruschini, H., Desmopressin versus behavioral modifications as initial treatment of primary nocturnal enuresis, Urologic Nursing, 31, 286–289, 2011 [PubMed: 22073899] | Population does not meet the inclusion criteria; Children under 12 |
| Friberg Felsted, K., Supiano, K. P., What is the feasibility and prelimimary efficacy of mindfulness-based stress reduction to treat symptoms of urinary incontinence in older adult women?, Journal of the American Geriatrics Society, 67 (Supplement 1), S227, 2019 | Conference abstract |
| Garley, A., Unwin, J., A case series to pilot cognitive behaviour therapy for women with urinary incontinence, British Journal of Health Psychology, 11, 373–86, 2006 [PubMed: 16870050] | Study design does not meet the inclusion criteria: non-randomised case series |
| Gaylord, S. A., Whitehead, W. E., Coble, R. S., Faurot, K. R., Palsson, O. S., Garland, E. L., Frey, W., Mann, J. D., Mindfulness for irritable bowel syndrome: protocol development for a controlled clinical trial, BMC Complementary & Alternative Medicine, 9, 24, 2009 [PMC free article: PMC2729728] [PubMed: 19638214] | No results, protocol paper |
| Gezginci, E., Iyigun, E., Yilmaz, S., Comparison of 3 Different Teaching Methods for a Behavioral Therapy Program for Female Overactive Bladder: A Randomized Controlled Trial, Journal of Wound, Ostomy, & Continence Nursing, 45, 68–74, 2018 [PubMed: 29300292] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Gezginci, E., Iyigun, E., Yilmaz, S., Aydur, E., Comparative effectiveness of three different teaching methods in behavioural therapy program for female overactive bladder: A randomized controlled trial, European Urology, Supplements, 14 (2), e263–e263a, 2015 | Conference abstract |
| Gezginci, E., Iyigun, E., Yilmaz, S., Aydur, E., Comparative effectiveness of three different teaching methods in behavioral therapy program for female overactive bladder: A randomized controlled trial, Journal of Urology, 1), e572, 2015 [PubMed: 29300292] | Conference abstract |
| Gomelsky,A., Dmochowski,R.R., Treatment of mixed urinary incontinence in women, Current Opinion in Obstetrics and Gynecology, 23, 371–375, 2011 [PubMed: 21836506] | Narrative review |
| Goode, P. S., Burgio, K. L., Locher, J. L., Umlauf, M. G., Lloyd, L. K., Roth, D. L., Urodynamic changes associated with behavioral and drug treatment of urge incontinence in older women, Journal of the American Geriatrics Society, 50, 808–16, 2002 [PubMed: 12028165] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Gulewitsch, M. D., Schlarb, A. A., Comparison of gut-directed hypnotherapy and unspecific hypnotherapy as self-help format in children and adolescents with functional abdominal pain or irritable bowel syndrome: a randomized pilot study, European journal of gastroenterology & hepatology, 29, 1351–1360, 2017 [PubMed: 29023318] | Population includes males and children under 12, cannot separate out the data on women |
| Hagen, S., McClurg, D., Bugge, C., Hay-Smith, J., Dean, S. G., Elders, A., Glazener, C., Abdel-Fattah, M., Agur, W. I., Booth, J., et al.,, Effectiveness and cost-effectiveness of basic versus biofeedback-mediated intensive pelvic floor muscle training for female stress or mixed urinary incontinence: protocol for the OPAL randomised trial, BMJ Open, 9, 2019 [PMC free article: PMC6411252] [PubMed: 30782895] | Intervention not psychological. Maybe suitable 8.1 |
| Hamid, N., Dehghanizadeh, Z., Firuzi, A. A., Effects of cognitive - behavioral therapy on sexual function in women with vaginismus disorder, Iranian Journal of Obstetrics, Gynecology and Infertility, 15, 2012 | Publication not in English, only available in Farsi |
| Harrison,J.D., Young,J.M., Solomon,M.J., Butow,P.N., Secomb,R., Masya,L., Randomized pilot evaluation of the supportive care intervention “CONNECT” for people following surgery for colorectal cancer, Diseases of the Colon and Rectum, 54, 622–631, 2011 [PubMed: 21471765] | Population does not meet the inclusion criteria, majority male population |
| Hu, T. W., Kaltreider, D. L., Igou, J. F., Yu, L. C., Rohner, T. J., Cost effectiveness of training incontinent elderly in nursing homes: a randomized clinical trial, Health Services Research, 25, 455–77, 1990 [PMC free article: PMC1065639] [PubMed: 2116385] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Hucker, A., McCabe, M. P., Incorporating Mindfulness and Chat Groups Into an Online Cognitive Behavioral Therapy for Mixed Female Sexual Problems, Journal of Sex Research, 52, 627–639, 2015 [PubMed: 24742343] | No reference to pelvic floor dysfunction |
| Johnson, A. K., Johnson, A. J., Barton, D., Elkins, G., Hypnotic Relaxation Therapy and Sexual Function in PostmenopausalWomen: Results of a Randomized Clinical Trial, International Journal of Clinical and Experimental Hypnosis, 64, 213–224, 2016 [PubMed: 26894424] | Sexual dysfunction not completely due pelvic floor dysfunction |
| Jones, G., Brennan, V., Jacques, R., Wood, H., Dixon, S., Radley, S., Evaluating the impact of a ‘virtual clinic’ on patient experience, personal and provider costs of care in urinary incontinence: A randomised controlled trial, PLoS ONE, 13 (1) (no pagination), 2018 [PMC free article: PMC5773012] [PubMed: 29346378] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Jones, L. M., McCabe, M. P., The effectiveness of an Internet-based psychological treatment program for female sexual dysfunction, Journal of Sexual Medicine, 8, 2781–92, 2011 [PubMed: 21771279] | Pelvic floor dysfunction not the cause of all sexual dysfunction |
| Kenton, K., Barber, M., Wang, L., Hsu, Y., Rahn, D., Whitcomb, E., Amundsen, C., Bradley, C. S., Zyczynski, H., Richter, H. E., Pelvic Floor Disorders, Network, Pelvic floor symptoms improve similarly after pessary and behavioral treatment for stress incontinence, Female Pelvic Medicine & Reconstructive Surgery, 18, 118–21, 2012 [PMC free article: PMC3423640] [PubMed: 22453323] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Kilinc, M. F., Doluoglu, O. G., Yildiz, Y., Yuceturk, C. N., Hascicek, A. M., Using a checklist to increase the effectiveness of behavioral therapy for overactive bladder: A prospective randomized controlled trial, Neurourology & Urodynamics, 38, 1152–1159, 2019 [PubMed: 30869820] | Population includes men and cannot separate out the data on women |
| Kilmann, P. R., Boland, J. P., Norton, S. P., Davidson, E., Caid, C., Perspectives of sex therapy outcome: a survey of AASECT providers, Journal of Sex & Marital Therapy, 12, 116–38, 1986 [PubMed: 2873253] | Narrative review |
| Kincade, J. E., Dougherty, M. C., Busby-Whitehead, J., Carlson, J. R., Nix, W. B., Kelsey, D. T., Smith, F. C., Hunter, G. S., Rix, A. D., Self-monitoring and pelvic floor muscle exercises to treat urinary incontinence, Urologic nursing : official journal of the American Urological Association Allied, 25, 353–363, 2005 [PubMed: 16294613] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Kinman, C. L., Meriwether, K. V., Powell, C. M., Hobson, D. T. G., Gaskins, J. T., Francis, S. L., Use of an iPadTM application in preoperative counseling for pelvic reconstructive surgery: a randomized trial, International Urogynecology Journal, 29, 1289–1295, 2018 [PubMed: 29167975] | No usable data |
| Klijn, A. J., Uiterwaal, C. S., Vijverberg, M. A., Winkler, P. L., Dik, P., de Jong, T. P., Home uroflowmetry biofeedback in behavioral training for dysfunctional voiding in school-age children: a randomized controlled study, Journal of Urology, 175, 2263–8; discussion 2268, 2006 [PubMed: 16697850] | Population do not meet the inclusion criteria, study includes children and data cannot be separated out |
| Komesu, Y. M., Rogers, R. G., Sapien, R., Hypnotherapy for treatment of overactive bladder: A pilot study, Journal of Pelvic Medicine and Surgery, 2), S86, 2010 [PMC free article: PMC4575591] [PubMed: 22453228] | Conference abstract |
| Komesu, Y. M., Rogers, R. G., Sapien, R. E., Schrader, R. M., Simmerman-Sierra, T., Mayer, A. R., Ketai, L. H., Methodology for a trial of brain-centered versus anticholinergic therapy in women with urgency urinary incontinence, International Urogynecology Journal, 28, 865–874, 2017 [PMC free article: PMC5393944] [PubMed: 27752750] | Protocol paper - no data reported |
| Komesu, Y. M., Schrader, R. M., Rogers, R. G., Sapien, R. E., Mayer, A. R., Ketai, L. H., Hypnotherapy or medications: a randomized noninferiority trial in urgency urinary incontinent women, American Journal of Obstetrics & Gynecology, 23, 23, 2019 [PMC free article: PMC6995419] [PubMed: 31449805] | Comparison does not meet the inclusion criteria, comparator arm receives medication |
| Komesu, Y. M., Schrader, R., Rogers, R. G., Sapien, R., Ketai, L. H., Hypnotherapy or pharmacotherapy for urgency urinary incontinence treatment in women. the hyp-hop randomized clinical trial, Female Pelvic Medicine and Reconstructive Surgery, 24 (5 Supplement 1), S4, 2018 | Conference abstract |
| Kristmanson, D., Wen, S., White, R., Black, A., Schachter, J., Effectiveness of a motivational interviewing workshop in decreasing decisional conflict in women with pelvic floor disorders: A randomized trial, Neurourology and Urodynamics, 36 (Supplement 3), S393–S394, 2017 | Conference abstract |
| Lackner, J. M., Quigley, B. M., Gudleski, G. D., Radziwon, C., Krasner, S. S., Hamilton, F. A., Ruminski, K. A., Brenner, D. M., Firth, R. S., Vargovich, A., Global Ibs Symptom Improvement in Cognitive-Behavioral Therapy-Treated Patients Is Associated with Clinically Important Changes in Abdominal Pain and Stool Consistency across All Bowel Types, Gastroenterology, 156 (6 S1), S-1062, 2019 | Conference abstract |
| Lavelle, E. S., Zyczynski, H. M., Stress Urinary Incontinence. Comparative Efficacy Trials, Obstetrics and Gynecology Clinics of North America, 43, 45–57, 2016 [PubMed: 26880507] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Lee, P. S., Reid, D. W., Saltmarche, A., Linton, L., Measuring the psychosocial impact of urinary incontinence: the York Incontinence Perceptions Scale (YIPS), Journal of the American Geriatrics Society, 43, 1275–8, 1995 [PubMed: 7594164] | Intervention does not meet the inclusion criteria; behavioural therapy |
| Leong, B. S., Mok, N. W., Effectiveness of a new standardised Urinary Continence Physiotherapy Programme for community-dwelling older women in Hong Kong, Hong Kong Medical Journal, 21, 30–7, 2015 [PubMed: 25377297] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Margolis,M.K., Fox,K.M., Cerulli,A., Ariely,R., Kahler,K.H., Coyne,K.S., Psychometric validation of the overactive bladder satisfaction with treatment questionnaire (OAB-SAT-q), Neurourology and Urodynamics, 28, 416–422, 2009 [PubMed: 19030182] | Population does not meet the inclusion criteria, males included and no separate analysis conducted on women |
| McClurg, D., Pollock, A., Campbell, P., Hazelton, C., Elders, A., Hagen, S., Hill, D. C., Conservative interventions for urinary incontinence in women: An Overview of Cochrane systematic reviews, Cochrane Database of Systematic Reviews, 2016 (9) (no pagination), 2016 | Protocol paper |
| McDowell, B. J., Engberg, S., Sereika, S., Donovan, N., Jubeck, M. E., Weber, E., Engberg, R., Effectiveness of behavioral therapy to treat incontinence in homebound older adults, Journal of the American Geriatrics Society, 47, 309–318, 1999 [PubMed: 10078893] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| McFall, S. L., Yerkes, A. M., Cowan, L. D., Outcomes of a small group educational intervention for urinary incontinence: episodes of incontinence and other urinary symptoms, Journal of Aging & Health, 12, 250–67, 2000 [PubMed: 11010699] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| McFall, S. L., Yerkes, A. M., Cowan, L. D., Outcomes of a small group educational intervention for urinary incontinence: health-related quality of life, Journal of Aging & Health, 12, 301–17, 2000 [PubMed: 11067699] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Melles, R. J., ter Kuile, M. M., Dewitte, M., van Lankveld, J. J., Brauer, M., de Jong, P. J., Automatic and deliberate affective associations with sexual stimuli in women with lifelong vaginismus before and after therapist-aided exposure treatment, Journal of Sexual Medicine, 11, 786–99, 2014 [PubMed: 24165436] | Outcomes not relevant; paper is looking at reaction times. Population is the same as Ter Kuile (included study 2013/2015). |
| Moossdorff-Steinhauser, H. F. A., Bols, E. M. J., Spaanderman, M. E. A., Dirksen, C. D., Weemhoff, M., Nieman, F. H. M., Berghmans, B., Long-term effects of motherfit group therapy in pre-(MOTHERFIT1) and post-partum women (MOTHERFIT2) with stress urinary incontinence compared to care-as-usual: Study protocol of two multi-centred, randomised controlled trials, Trials, 20 (1) (no pagination), 2019 [PMC free article: PMC6485130] [PubMed: 31023381] | Study Protocol, no results |
| Mosalanejad, F., Afrasiabifar, A., Zoladl, M., Investigating the combined effect of pelvic floor muscle exercise and mindfulness on sexual function in women with multiple sclerosis: a randomized controlled trial, Clinical Rehabilitation, 32, 1340–1347, 2018 [PubMed: 29843529] | Does not specify that sexual dysfunction is associated with pelvic floor dysfunction |
| Myers, E. M., Robinson, B. L., Geller, E. J., Wells, E., Matthews, C. A., Fenderson, J. L., Crane, A. K., Jannelli, M., Connolly, A., Randomized trial of a web-based tool for prolapse: impact on patient understanding and provider counseling, International Urogynecology Journal, 25, 1127–32, 2014 [PubMed: 24652032] | Not Validated questionnaire |
| Myers, E. M., Robinson, B. L., Geller, E. J., Wells, E., Matthews, C. A., Fenderson, J. L., Crane, A. K., Jannelli, M., Connolly, A., Interactive web-based tool for pelvic organ prolapse: Impact on patient understanding and provider counseling, Journal of Minimally Invasive Gynecology, 1), S57, 2013 [PubMed: 24652032] | Conference abstract |
| Myers, E. M., Robinson, B., Geller, E., Wells, E., Matthews, C., Fenderson, J., Crane, A., Jannelli, M., Connolly, A., Interactive web-based patient/provider counseling and pelvic organ prolapse: Do patients better understand and do providers better counsel?, International Urogynecology Journal and Pelvic Floor Dysfunction, 24, S87, 2013 | Conference abstract |
| Myers, E., Robinson, B. L., Geller, E. J., Wells, E., Matthews, C. A., Fenderson, J. L., Crane, A. K., Jannelli, M., Connolly, A., Interactive web-based tool for pelvic organ prolapse: Impact on patient understanding and provider counseling, Female Pelvic Medicine and Reconstructive Surgery, 19, S131–S132, 2013 | Conference abstract |
| Norton, C., Chelvanayagam, S., Wilson-Barnett, J., Redfern, S., Kamm, M. A., Randomized controlled trial of biofeedback for fecal incontinence, Gastroenterology, 125, 1320–9, 2003 [PubMed: 14598248] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Norton, C., Dibley, L. B., Hart, A., Duncan, J., Emmanuel, A., Knowles, C. H., Stevens, N., Terry, H., Verjee, A., Kerry, S., Hounsome, N., Faecal incontinence intervention study (FINS): self-management booklet information with or without nurse support to improve continence in people with inflammatory bowel disease: study protocol for a randomized controlled trial, Trials, 16, 2015 [PMC free article: PMC4594995] [PubMed: 26445224] | IBS not Pelvic Floor Dysfunction |
| Oakley, S. H., Ghodsi, V. C., Crisp, C. C., Estanol, M. V., Westermann, L. B., Novicki, K. M., Kleeman, S. D., Pauls, R. N., Effects of physical therapy on pelvic floor symptoms and quality of life in postpartum women following severe perineal trauma: a randomized controlled trial, Female pelvic medicine & reconstructive surgery, 21, S18, 2015 [PubMed: 26829343] | Conference |
| Oh, H. S., Kim, M. K., Seo, W. S., Effectiveness of a behavioral intervention program for urinary incontinence in a community setting, Taehan Kanho Hakhoe chi, 35, 1476–1484, 2005 [PubMed: 16415628] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Oh-oka, H., Usefulness of long-term dietary manipulation for female patients with painful bladder syndrome/interstitial cystitis, Neurourology and urodynamics, 37, S115–S116, 2018 | Conference |
| Osborne, L. A., Reed, P., A Review of Hypnotherapy for Overactive Bladder, International Journal of Clinical & Experimental Hypnosis, 67, 278–296, 2019 [PubMed: 31251708] | Narrative review, RCTs checked |
| Osborne, L. A., Whittall, C. M., Emanuel, R., Emery, S., Reed, P., Randomized Controlled Trial of the Effect of a Brief Telephone Support Intervention on Initial Attendance at Physiotherapy Group Sessions for Pelvic Floor Problems, Archives of Physical Medicine and Rehabilitation, 98, 2247–2252, 2017 [PubMed: 28526481] | Intervention does not meet the inclusion criteria; the intervention is a phone call to increase attendance, not to give psychological support |
| Palmer, M. H., Marquez, C. S., Li, Y., Hawkins, S. Y., Smith, F., Busby-Whitehead, J., A Feasibility Study for a Posthospital Intervention for Lower Urinary Tract Symptoms in Adults With Heart Failure, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society, 42, 539–546, 2015 [PubMed: 26336050] | Population includes males, can’t separate out females |
| Peters, S., Yao, C. K., Shepherd, S., Philpott, H., Yelland, G., Muir, J. G., Gibson, P. R., Gut-directed hypnotherapy and a low fodmap diet are similarly efficacious in patients with irritable bowel syndrome: A randomised controlled non-inferiority trial, Gastroenterology, 1), S487–S488, 2015 | Conference abstract |
| Pitia, A. P., Saskia Tavares, J., Teixeira, B., Teles, A., Lemos, A., Nogueira, A., Brasil, C., Lordelo, P., The effectiveness of cbt in the sexual function and quality of life of women with sexual dysfunction: A comparative study, Neurourology and Urodynamics, 37 (Supplement 5), S232–S233, 2018 | Conference abstract |
| Pitia, A. P., Tavares, J., Teixeira, B., Brasil, C., Lemos, A., Campos, R., Nogueira, A., Sodre, D., Mascarenhas, I., Lordelo, P., The influence of cognitive-behavioral psychotherapy on the sexual function and quality of life of women with sexual dysfunction: Preliminary results: Of the randomized clinical trial using quantitative and qualitative metrics, Neurourology and Urodynamics, 37 (Supplement 5), S415–S416, 2018 | Conference abstract |
| Rajalaxmi, V., Varalakshmi, S., Suresh, V. H., Kumar, G. M., Kamatchi, K., Vaishnavi, G., Muthukumaran, N., Efficacy of pelvic floor muscle training, yoga and cognitive behavioural therapy for urinary incontinence in diabetic women - a randomized controlled double blinded study, Research Journal of Pharmacy and Technology, 12, 4618–4622, 2019 | Conference abstract |
| Rao, S. S. C., Valestin, J. A., Xiang, X., Hamdy, S., Bradley, C. S., Zimmerman, M. B., Home-based versus office-based biofeedback therapy for constipation with dyssynergic defecation: a randomised controlled trial, The Lancet Gastroenterology and Hepatology, 3, 768–777, 2018 [PMC free article: PMC6206847] [PubMed: 30236904] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Richter, H. E., Burgio, K. L., Brubaker, L., Nygaard, I. E., Ye, W., Weidner, A., Bradley, C. S., Handa, V. L., Borello-France, D., Goode, P. S., Zyczynski, H., Lukacz, E. S., Schaffer, J., Barber, M., Meikle, S., Spino, C., Pelvic Floor Disorders, Network, Continence pessary compared with behavioral therapy or combined therapy for stress incontinence: a randomized controlled trial, Obstetrics & Gynecology, 115, 609–17, 2010 [PMC free article: PMC2914312] [PubMed: 20177294] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Safarzadeh, A., Navidian, A., Dastyar, N., The effect of assertiveness-based sexual counselling on sexual function among married female students, International Journal of Women’s Health and Reproduction Sciences, 6, 342–349, 2018 | Does not specify if sexual function is associated with pelvic floor dysfunctions |
| Sampselle, C. M., Messer, K. L., Seng, J. S., Raghunathan, T. E., Hines, S. H., Diokno, A. C., Learning outcomes of a group behavioral modification program to prevent urinary incontinence, International Urogynecology Journal, 16, 441–446, 2005 [PubMed: 16237512] | Incorrect population (preventative intervention, population is symptom free) |
| Samuelsson, E., Nystrom, E., Soderstrom, L., Treatment for stress urinary incontinence with the support of a mobile application is effective when implemented for free use, Neurourology and Urodynamics, 35 (Supplement 4), S92–S94, 2016 | Conference abstract |
| Schnelle, J. F., Traughber, B., Morgan, D. B., Embry, J. E., Binion, A. F., Coleman, A., Management of geriatric incontinence in nursing homes, Journal of Applied Behavior Analysis, 16, 235–41, 1983 [PMC free article: PMC1307878] [PubMed: 6885672] | Population includes males, can’t separate females |
| Schnyder, U., Schnyder-Luthi, C., Ballinari, P., Blaser, A., Therapy for vaginismus: in vivo versus in vitro desensitization, Canadian Journal of Psychiatry - Revue Canadienne de Psychiatrie Can J Psychiatry, 43, 941–4, 1998 [PubMed: 9825167] | No outcome data provided. The paper does not provide data per intervention group |
| Schover,L.R., Yuan,Y., Fellman,B.M., Odensky,E., Lewis,P.E., Martinetti,P., Efficacy trial of an Internet-based intervention for cancer-related female sexual dysfunction, Journal of the National Comprehensive Cancer Network, 11, 1389–1397, 2013 [PMC free article: PMC3831175] [PubMed: 24225972] | Not Pelvic Floor Dysfunction, related to cancer |
| Seabrook, J. A., Gorodzinsky, F., Freedman, S., Treatment of primary nocturnal enuresis: A randomized clinical trial comparing hypnotherapy and alarm therapy, Paediatrics and Child Health, 10, 609–610, 2005 [PMC free article: PMC2722618] [PubMed: 19668674] | Incorrect population (60% male, mean age 9.1 years) |
| Sharma, V., Saito, Y., Amit, S., Mind-body medicine and irritable bowel syndrome: a randomized control trial using stress reduction and resiliency training, Journal of alternative and complementary medicine (New York, N.Y.), 20, A94, 2014 | Conference abstract |
| Simon, M. A., Bueno, A. M., Efficacy of Biofeedback Therapy in the Treatment of Dyssynergic Defecation in Community-Dwelling Elderly Women, Journal of Clinical Gastroenterology, 51, e90–e94, 2017 [PubMed: 28059942] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Sjostrom, M., Lindholm, L., Samuelsson, E., Mobile App for Treatment of Stress Urinary Incontinence: A Cost-Effectiveness Analysis, Journal of medical Internet research, 19, e154, 2017 [PMC free article: PMC5440735] [PubMed: 28483745] | Health Economic study |
| Sjostrom, M., Umefjord, G., Stenlund, H., Carlbring, P., Andersson, G., Samuelsson, E., Internet-based treatment of stress urinary incontinence: 1- and 2-year results of a randomized controlled trial with a focus on pelvic floor muscle training, BJU International, 116, 955–64, 2015 [PMC free article: PMC4690161] [PubMed: 25683075] | Intervention not psychological, suitable for 8.1 |
| Sjostrom, M., Umefjord, G., Stenlund, H., Carlbring, P., Andersson, G., Samuelsson, E., Internet-based treatment of stress urinary incontinence: A randomised controlled study, Neurourology and Urodynamics, 31 (6), 734–736, 2012 | Conference abstract |
| Sjostrom, M., Umefjord, G., Stenlund, H., Carlbring, P., Andersson, G., Samuelsson, E., Internet-based treatment of stress urinary incontinence: A randomised controlled study with focus on pelvic floor muscle training, BJU international, 112, 362–372, 2013 [PMC free article: PMC3798106] [PubMed: 23350826] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Stephenson, K. R., Kerth, J., Effects of Mindfulness-Based Therapies for Female Sexual Dysfunction: A Meta-Analytic Review, Journal of Sex Research J Sex Res, 54, 832–849, 2017 [PubMed: 28617103] | Systematic review, references checked for relevance, no reference to pelvic floor dysfunction |
| Stravynski, A., Gaudette, G., Lesage, A., Arbel, N., Bounader, J., Lachance, L., Clerc, D., Fabian, J., Lamontagne, Y., Langlois, R., Lipp, O., Sidoun, P., The treatment of sexually dysfunctional women without partners: A controlled study of three behavioural group approaches, Clinical Psychology and Psychotherapy, 14, 211–220, 2007 | No mention of pelvic floor dysfunction |
| Subak, L. L., Quesenberry, C. P., Posner, S. F., Cattolica, E., Soghikian, K., The effect of behavioral therapy on urinary incontinence: a randomized controlled trial, Obstetrics & Gynecology Obstet Gynecol, 100, 72–8, 2002 [PubMed: 12100806] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Sudol, N. T., Garg, N., Adams-Piper, E., Jacobs, S., Lane, F. L., Upgrades in patient education: Assessing the utility of an iPad application in pelvic organ prolapse comprehension and counseling satisfaction, American Journal of Obstetrics and Gynecology, 218 (2 Supplement 2), S928–S929, 2018 | Conference abstract |
| Supiano, K. P., Felsted, K. F., Treating urge urinary incontinence in older adult women with complementary therapies: A feasibility and randomized controlled trial utilizing MBSR and hep, Global Advances in Health and Medicine, 7, 223, 2018 | Conference abstract |
| Tak, E. C., van Hespen, A., van Dommelen, P., Hopman-Rock, M., Does improved functional performance help to reduce urinary incontinence in institutionalized older women? A multicenter randomized clinical trial, BMC Geriatrics, 12, 51, 2012 [PMC free article: PMC3495708] [PubMed: 22953994] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Ter Kuile, M. M., Melles, R. J., Tuijnman-Raasveld, C. C., de Groot, H. E., van Lankveld, J. J., Therapist-Aided Exposure for Women with Lifelong Vaginismus: Mediators of Treatment Outcome: A Randomized Waiting List Control Trial, Journal of Sexual Medicine, 12, 1807–19, 2015 [PubMed: 26247327] | Same study population, and outcomes as in Ter Kuile 2013 (included study) |
| ter Kuile, M. M., van Lankveld, J. J. D. M., Groot, E. d, Melles, R., Neffs, J., Zandbergen, M., Cognitive-behavioral therapy for women with lifelong vaginismus: Process and prognostic factors, Behaviour Research and Therapy, 45, 359–373, 2007 [PubMed: 16701078] | Outcomes not relevant; paper is comparing responders and non-responders not intervention and control, and unable to determine which arm participants were originally enrolled in. Population the same as van Lankveld 2006 (included study). |
| Teunissen, T. A., de Jonge, A., van Weel, C., Lagro-Janssen, A. L., Treating urinary incontinence in the elderly--conservative therapies that work: a systematic review, Journal of Family Practice, 53, 25–30, 32, 2004 [PubMed: 14709263] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Van Den Heuvel, E., Tannenbaum, C., Wagg, A., Fritel, X., Lavoie, M., Dorais, J., Continence across continents to upend stigma and dependency (CACTUSD): feasibility of an international randomized controlled trial of a continence promotion intervention, Neurourology and Urodynamics, 34, S207, 2015 | Conference abstract |
| Velez, J. B., Behavior therapy for urge incontinence in older women, Journal of Family Practice, 48, 168–9, 1999 [PubMed: 10086751] | Narrative review |
| Weidner, A. C., Barber, M. D., Markland, A. D., Rahn, D. D., Hsu, Y., Mueller, E. R., Jakuswaldman, S., Dyer, K. Y., Warren, L. K., Gantz, M., et al.,, Perioperative behavioral therapy & pelvic muscle strengthening does not improve quality of life after apical prolapse surgery: a randomized controlled trial, International Urogynecology Journal and Pelvic Floor Dysfunction, 26, S59–S60, 2015 | Patients receiving surgery |
| Weidner, A. C., Barber, M. D., Markland, A. D., Rahn, D. D., Hsu, Y., Mueller, E. R., Jakus-Waldman, S., Dyer, K. Y., Warren, L. K., Gantz, M., et al.,, Perioperative behavioral therapy & pelvic muscle strengthening does not improve quality of life after apical prolapse surgery: a randomized, controlled trial, Female Pelvic Medicine & Reconstructive Surgery Female pelvic med, 21, S67–S68, 2015 | Patients received surgery |
| Weidner, A. C., Barber, M. D., Markland, A., Rahn, D. D., Hsu, Y., Mueller, E. R., Jakus-Waldman, S., Dyer, K. Y., Warren, L. K., Gantz, M. G., Meikle, S., Perioperative Behavioral Therapy and Pelvic Muscle Strengthening Do Not Enhance Quality of Life After Pelvic Surgery: Secondary Report of a Randomized Controlled Trial, Physical therapy, 97, 1075–1083, 2017 [PMC free article: PMC6075557] [PubMed: 29077924] | Patients received surgery |
| Wyman, J. F., Fantl, J. A., McClish, D. K., Harkins, S. W., Uebersax, J. S., Ory, M. G., Quality of life following bladder training in older women with urinary incontinence, International Urogynecology Journal, 8, 223–229, 1997 [PubMed: 9449301] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Wyman,J.F., Fantl,J.A., McClish,D.K., Bump,R.C., Comparative efficacy of behavioral interventions in the management of female urinary incontinence. Continence Program for Women Research Group, American Journal of Obstetrics and Gynecology, 179, 999–1007, 1998 [PubMed: 9790388] | Intervention does not meet the inclusion criteria; no psychological aspect to the intervention |
| Treating UI with behavioural therapies, Canadian Nursing Home, 7, 11–18, 1996 | Narrative summary of care |
| Treating urge incontinence, Nurses’ Drug Alert, 32, 51–51, 2008 | Conference abstract |
| Manage vulvodynia using a multimodal and individualized approach, Drugs and Therapy Perspectives, 35, 612–617, 2019 | Narrative review |
| Pill-free treatment for urinary incontinence, Harvard Health Letter, 44, 8–8, 2019 | Online news brief |
| Continence Promotion and Care, Nursing Times, 6-6, 2019 | Full text unavailable from the British Library |
| Abbasy, S. A., Michelfelder, A., Kenton, K., Mueller, E. R., FitzGerald, M. P., Home-based cognitive therapy for overactive bladder, Journal of Urology, 1), 561, 2009 | Conference abstract |
| Addison, R., Establishing a user group in continence care, Nursing Times, 98, 60–1, 2002 [PubMed: 12008270] | Online brief report |
| Adelstein, S. A., Lee, U. J., The Role of Mindfulness in Urinary Urgency Symptoms, Current Bladder Dysfunction Reports, 11, 38–44, 2016 | Narrative review |
| Aeyoung, So, De Gagne, Jennie C., Sunah, Park, Long-Term Effects of a Self-management Program for Older Women With Urinary Incontinence in Rural Korea: A Comparison Cohort Study, Journal of Wound, Ostomy & Continence Nursing, 46, 55–61, 2019 [PubMed: 30608342] | Intervention does not meet the inclusion criteria: intervention based on self-management and self-efficacy (behavioural and PFMT) |
| Althof, S. E., It was the best of times; it was the worst of times, Journal of Sex and Marital Therapy, 33, 399–403, 2007 [PubMed: 17674217] | Commentary paper |
| Anonymous,, Patient information page from the Hormone Health Network. Female sexual dysfunction, Journal of Clinical Endocrinology & Metabolism, 97, 39A–40A, 2012 [PubMed: 23223491] | Patient fact sheet |
| Anonymous,, National association for continence launches nationwide support groups, Urologic nursing : official journal of the American Urological Association Allied, 20, 141, 2000 [PubMed: 11998126] | Narrative summary paper |
| Anonymous,, Retraining an overactive bladder. Self-help strategies that can effectively treat an ‘urgent’ problem, Johns Hopkins Medical Letter, Health After 50Johns Hopkins Med Lett Health After 50, 24, 5–8, 2012 [PubMed: 23757783] | Narrative summary providing advice to those with overactive bladder |
| Anonymous,, Female sexual dysfunction, International Journal of Impotence Research, 15, S22–S26, 2003 [PubMed: 14695969] | Short report on classification and prevalence of female sexual dysfunction |
| Anonymous,, Behavior therapy and urge incontinence, Mayo Clinic health letter (English ed.), 21, 4, 2003 [PubMed: 12772684] | Abstract overview |
| Arnouk, A., De, E., Rehfuss, A., Cappadocia, C., Dickson, S., Lian, F., Physical, Complementary, and Alternative Medicine in the Treatment of Pelvic Floor Disorders, Current Urology Reports, 18, 47, 2017 [PubMed: 28585105] | Narrative review (references checked) |
| Arulkumaran, S., Johnson, T. R. B., Contemporary issues in women’s health, International Journal of Gynecology and Obstetrics, 83, 1–3, 2003 [PubMed: 14626289] | Narrative review |
| Asoglu, Mehmet, Beginoglu, Özlem, Demir, Mustafa, Çelik, Hakim, Fedai, Ülker, Akil, Öznur, Ayaydin, Hamza, Kilicaslan, Fethiye, Retrospective Analysis of Vaginismus Patients Referred to Psychiatric Outpatient Clinic in a University Hospital, Journal of Harran University Medical Faculty, 16, 569–572, 2019 | Study design does not meet the inclusion criteria: Retrospective study |
| Backman, H., Widenbrant, M., Bohm-Starke, N., Dahlof, L. G., Combined physical and psychosexual therapy for provoked vestibulodynia-an evaluation of a multidisciplinary treatment model, Journal of Sex Research, 45, 378–85, 2008 [PubMed: 18937129] | Population does not meet the inclusion criteria, women do not have pelvic floor dysfunction |
| Baker, J., Costa, D., Nygaard, I., Mindfulness-based stress reduction for treatment of urinary urge incontinence: a pilot study, Female Pelvic Medicine & Reconstructive Surgery, 18, 46–9, 2012 [PubMed: 22453268] | study design does not meet the inclusion criteria: Single arm study, no comparator group |
| Bakes, Emma, Pelvic Floor Physiotherapy and Psychological Support: Why Do Patients Fail to Complete Their Rehab?, Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 78–79, 2018 | Full text unavailable from the British Library |
| Banerjee, S., Srivastav, A., Palan, B. M., Hypnosis and self-hypnosis in the management of nocturnal enuresis: A comparative study with imipramine therapy, American Journal of Clinical Hypnosis, 36, 113–119, 1993 [PubMed: 8259762] | Population does not meet the inclusion criteria: children aged 5 to 16 years |
| Barnes, J., Primary vaginismus (part 2): Aetiological factors, Irish Medical Journal, 79, 62–65, 1986 [PubMed: 3700069] | Study design does not meet the inclusion criteria, study groups women according to aetiology, no intervention is given |
| Barnes, J., Bowman, E. P., Cullen, J., Biofeedback as an adjunct to psychotherapy in the treatment of vaginismus, Biofeedback & Self Regulation, 9, 281–9, 1984 [PubMed: 6525355] | Study design does not meet the inclusion criteria: Case series - single arm intervention, no comparator group |
| Beck, J. Gayle, Vaginismus, 381–397, 1993 | Book chapter |
| Benoit-Piau, J., Bergeron, S., Brassard, A., Dumoulin, C., Khalife, S., Waddell, G., Morin, M., Fear-avoidance and Pelvic Floor Muscle Function are Associated With Pain Intensity in Women With Vulvodynia, Clinical Journal of PainClin J Pain, 34, 804–810, 2018 [PubMed: 29528864] | Population does not meet the inclusion criteria, women do not have pelvic floor dysfunction |
| Bergeron, S., Lord, M., The integration of pelvi-perineal re-education and cognitive behavioural therapy in the multidisciplinary treatment of the sexual pain disorders…Reprinted from Sexual and Relationship Therapy, Vol. 18, No. 2, 2003, 135–141, Sexual & Relationship Therapy, 25, 299–305, 2010 | Narrative review |
| Bergeron, S., Morin, M., Lord, M., Integrating pelvic floor rehabilitation and cognitive-behavioural therapy for sexual pain: what have we learned and where do we go from here?, Sexual & Relationship Therapy, 25, 289–298, 2010 | Narrative review |
| Bergeron, Sophie, Lord, Marie-Josee, The integration of pelvi-perineal re-education and cognitive-behavioural therapy in the multidisciplinary treatment of the sexual pain disorders, Sexual and Relationship Therapy, 18, 135–141, 2003 | Narrative review |
| Bernorio, R., Di Santo, S., Mori, G., Prunas, A., The effectiveness of body-mind connection therapy in the treatment of lifelong vaginismus, Journal of Sexual Medicine, 1), 11, 2014 | Conference abstract |
| Björk, Anna-Bell, Sjöström, Malin, Johansson, Eva E., Samuelsson, Eva, Umefjord, Göran, Women’s Experiences of Internet-Based or Postal Treatment for Stress Urinary Incontinence, Qualitative Health Research, 24, 484–493, 2014 [PubMed: 24598777] | Study design does not meet the inclusion criteria: Qualitative study |
| Black, P. A., Urinary incontinence: a many faceted problem, Professional Nurse, 5, 378–84, 1990 [PubMed: 2343054] | Summary paper |
| Borrie, M., Bawden, M., Speechley, M., Kloseck, M., Rigby, D., Roe, B., Nurse-led behavioural and lifestyle counselling may reduce incontinence, Evidence-Based Healthcare, 6, 143–144, 2002 | Conference abstract |
| Brady, L., Prompted voiding yields results. CNAs are key to the success of a pilot study that reduced urinary incontinence for residents of one Illinois facility, Provider, 35, 41–4, 2009 [PubMed: 19326800] | Narrative summary paper |
| Brown, Claire, The TOPSY trial, Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 95–96, 2018 | Full text unavailable from the British Library (likely a conference abstract) |
| Brown, J., Thomas, E., Continence. Help is only a call away, Nursing Times, 85, 81, 1989 [PubMed: 2726540] | Full text unavailable from the British Library |
| Brown, J., Thomas, E., Continence. Hot lines, Nursing Times, 91, 61–2, 1995 [PubMed: 7885895] | Full text unavailable from the British Library |
| Brown, J., Thomas, E., White, H., McCallum, A., An incontinence helpline service, Nursing Standard, 5, 25–7, 1991 [PubMed: 1907173] | Narrative summary paper |
| Burgio, K. L., Goode, P. S., Locher, J. L., Umlauf, M. G., Roth, D. L., Richter, H. E., Varner, R. E., Lloyd, L. K., Waetjen, L. E., Biofeedback did not improve the results of behavioural training for urge urinary incontinence in older women, Evidence-based Obstetrics and Gynecology, 5, 84–85, 2003 | Intervention does not meet the inclusion criteria: intervention based on behaviour not psychology |
| Callif, Debbie, Mindfulness in Pelvic Floor Dysfunction, Biofeedback, 46, 21–24, 2018 | Study design does not meet the inclusion criteria: case reports of three women |
| Carey, Michael P., Cognitive-behavioral treatment of sexual dysfunctions, 251–280, 1998 | Book chapter |
| Carone Craig, A. R., Psychological counseling in enuretic patients, Urodinamica, 11, 19–24, 2001 | Population does not meet the inclusion criteria, study only includes children |
| Chelvanayagam, S., Stern, J., Using therapeutic groups to support women with faecal incontinence, British Journal of Nursing, 16, 214–8, 2007 [PubMed: 17363851] | Narrative review |
| Colling, J., Owen, T. R., McCreedy, M., Newman, D., The effects of a continence program on frail community-dwelling elderly persons, Urologic Nursing, 23, 117–22, 127–31, 2003 [PubMed: 12778826] | Intervention does not meet the inclusion criteria: behavioural training study |
| Crowley, T., Goldmeier, D., Hiller, J., Diagnosing and managing vaginismus, BMJ (Online), 339, 225–229, 2009 [PubMed: 19541697] | Clinical review paper |
| da Maia Lima, Claudia Feio, Pereira Caldas, Célia, Correa Trotte, Liana Amorim, Oliveira Ferreira, Antônio Milton, Corrêa da Silva, Bárbara Martins, BEHAVIORAL THERAPY FOR THE URINARY INCONTINENCE OF ELDERLY WOMAN, Journal of Nursing UFPE / Revista de Enfermagem UFPE, 9, 8762–8770, 2015 | Study design does not meet the inclusion criteria; single arm study. Additionally, the intervention is unclear |
| Demain, S., Smith, J. F., Hiller, L., Dziedzic, K., Comparison of group and individual physiotherapy for female urinary incontinence in primary care: pilot study, Physiotherapy, 87, 235–242, 2001 | Intervention does not meet the inclusion criteria; the intervention compared bladder training to pelvic floor muscle training in a group or individually |
| Donohoe, G., Sensitivity can break the taboo. Female sexual problems and treatment approaches, Professional Nurse, 7, 304–8, 1992 [PubMed: 1738780] | Narrative review |
| Dow, Michael G., A controlled comparative evaluation of conjoint counselling and self-help behavioural treatment for sexual dysfunction, Dissertation Abstracts International Section C: Worldwide, 75, No Pagination Specified, 2018 | Thesis, no published article identified |
| Dowd, T., Dowd, E. T., A cognitive therapy approach to promote continence, Journal of Wound, Ostomy, & Continence Nursing, 33, 63–8, 2006 [PubMed: 16444107] | Narrative review |
| Elder, J. S., Bladder rehabilitation, the effect of a cognitive training programme on urge incontinence, Journal of Urology, 158, 1642, 1997 [PubMed: 9302192] | Abstract and editorial comment |
| Engel, B. T., Burgio, L. D., McCormick, K. A., Hawkins, A. M., Scheve, A. A., Leahy, E., Behavioral treatment of incontinence in the long-term care setting, Journal of the American Geriatrics Society, 38, 361–3, 1990 [PubMed: 2107245] | Intervention does not meet the inclusion criteria; intervention based on toilet training |
| Fera, P., Lelis, M. A., Glashan, R. Q., Nogueira, M. P., Bruschini, H., Behavioral interventions in primary enuresis: experience report in Brazil, Urologic nursing : official journal of the American Urological Association Allied, 22, 257–262, 2002 [PubMed: 12242898] | Population do not meet the inclusion criteria; children aged 6 to 13 years |
| Fireman, G., Nocturnal enuresis: Psychological correlates and behavior therapy, Children’s Hospital Quarterly, 1, 349–352, 1989 | Population does not meet the inclusion criteria; children only included |
| Freeman, R., A psychological approach to detrusor instability incontinence in women, Stress Medicine, 3, 9–14, 1987 | Study design does not meet the inclusion criteria; single arm study, no comparator group |
| Freeman, R. M., Baxby, K., Hypnotherapy for incontinence caused by the unstable detrusor, British Medical Journal Clinical Research Ed.Br Med J (Clin Res Ed), 284, 1831–4, 1982 [PMC free article: PMC1498778] [PubMed: 6805716] | Study design does not meet the inclusion criteria; single arm study, no comparator group |
| Garner, Ginger, Garner, Laverne, Yoga and Geriatric Pelvic Health, Notes, 27, 11–14, 2020 | Full text unavailable from the British Library |
| Gezginci, Elif, Iyigun, Emine, Yilmaz, Sercan, Comparison of 3 Different Teaching Methods for a Behavioral Therapy Program for Female Overactive Bladder: A Randomized Controlled Trial, Journal of Wound, Ostomy & Continence Nursing, 45, 68–74, 2018 [PubMed: 29300292] | Intervention does not meet the inclusion criteria |
| Golder, J., Treatment of enuresis. A personal approach in general practice, Australian family physician, 15, 1413, 1416, 1986 [PubMed: 3800761] | Narrative review |
| Gray, M., Beitz, J. M., Counseling patients undergoing urinary diversion: Does the type of diversion influence quality of life?, Journal of Wound, Ostomy and Continence Nursing, 32, 7–15, 2005 [PubMed: 15718951] | Systematic review; review on a surgical interventions, and therefore not relevant |
| Gunzler, Cindy, Berner, Michael M., Efficacy of psychosocial interventions in men and women with sexual dysfunctions-A systematic review of controlled clinical trials: Part 2-The efficacy of psychosocial interventions for female sexual dysfunction, Journal of Sexual Medicine, 9, 3108–3125, 2012 [PubMed: 23088366] | Systematic review, references checked for relevance |
| Hall, C., Advising on continence, Community Outlook Community Outlook, 38–43, 1990 [PubMed: 2376118] | Full text unavailable from the British Library |
| Hesnan, K., ET nurses expanding our practice. Behavioral interventions for incontinence, Ostomy Wound Management, 38, 12, 14–6, 17 passim, 1992 [PubMed: 1418283] | Full text unavailable from the British Library |
| Hill, L. A., Fereday-Smith, J., Credgington, C., Woodward, A. F., Knight, J. C., Williams, A. J., Doughty, G., Lamb, S. E., Pepper, J., Lall, R., Clarke, M., Bladders behaving badly: a randomized controlled trial of group versus individual interventions in the management of female urinary incontinence, Journal of the Association of Chartered Physiotherapists in Women’s Health, 30–36, 2007 | Intervention does not meet the inclusion criteria: group education (include for 6.2) |
| Hiller, J., Psychotherapy works, Sexual & Relationship Therapy, 21, 385–389, 2006 | Narrative review |
| Hocking, J., Continence problems: how to tackle reticence of patients, Nursing Times, 95, 56–8, 1999 [PubMed: 10067578] | Narrative review |
| Hunt, J., Psychological approaches to the management of sensory urgency and idiopathic detrusor instability, British Journal of Urology, 77, 339–41, 1996 [PubMed: 8814834] | Narrative review |
| Igbedioh, Carlene, Williams, Andrew B., Schizas, Alexis, Introducing a pelvic floor telephone assessment service, Journal of Community Nursing, 28, 59–65, 2014 | Intervention does not meet the inclusion criteria; study tests a telephone triage for assessment of patients |
| Irwin, B., User support groups in continence care, Nursing Times, 96, 24, 2000 [PubMed: 11963701] | Descriptive summary of a support service |
| Jacobson, A. F., Winslow, E. H., Treatment for nocturnal enuresis, The American journal of nursing, 99, 22, 1999 [PubMed: 10579018] | Population does not meet the inclusion criteria; children with enuresis |
| Janeway, Megan, Baum, Neil, Smith, Ryan, Sexual dysfunction in older women, Clinical Geriatrics, 20, 16–20, 2012 | Narrative review |
| Johnson, Aimee K., Johnson, Alisa J., Barton, Debra, Elkins, Gary, Hypnotic Relaxation Therapy and Sexual Function in PostmenopausalWomen: Results of a Randomized Clinical Trial, International Journal of Clinical & Experimental Hypnosis, 64, 213–224, 2016 [PubMed: 26894424] | Population does not meet the inclusion criteria; healthy women were recruited |
| Johnson, C., Accentuate the positive, Nursing Times, 95, 81, 1999 [PubMed: 10373920] | Personal experience |
| Jones, L. M., McCabe, M. P., The effectiveness of an Internet-based psychological treatment program for female sexual dysfunction, Journal of Sexual Medicine, 8, 2781–92, 2011 [PubMed: 21771279] | Population does not meet the inclusion criteria; women did not have pelvic floor dysfunction |
| Kabakci, E., Batur, S., Who benefits from cognitive behavioral therapy for vaginismus?, Journal of Sex & Marital Therapy, 29, 277–88, 2003 [PubMed: 14504016] | Study design does not meet the inclusion criteria; single arm study, no comparator group included |
| Kangchai, W., Srisuphun, W., Kompayak, J., Charoenyooth, C., Jitapunkul, S., Efficacy of self-management promotion program for elderly women with urinary incontinence, Thai Journal of Nursing Research, 6, 101–114, 2002 | Full text unavailable from the British Library |
| Karimi, Farzaneh, Babazadeh, Raheleh, Asgharipour, Negar, Esmaily, Habibollah, Roudsari, Robab Latifnejad, The Effectiveness of Counseling using PLISSIT Model on Depression, Anxiety and Stress, among Postpartum Women with Sexual Dysfunction: A Randomized Trial, Journal of Midwifery & Reproductive Health, 7, 1912–1920, 2019 | Population does not meet the inclusion criteria; women do not have pelvic floor dysfunction |
| Keachie, J., Continence. Island life, Nursing Times, 89, 72, 74, 76, 1993 [PubMed: 8415106] | Full text unavailable from the British Library |
| Kingsberg, S. A., Lecture 4: Clinical approaches to women’s sexual dysfunctions, International Journal of Impotence Research, 13, S44–S46, 2001 [PubMed: 11781747] | Narrative review and presentation |
| Knauf, K., A good poop, The journal of pastoral care & counseling : JPCC, 59, 139–140, 2005 [PubMed: 15943155] | Commentary paper |
| Lekan-Rutledge, D., Colling, J., Urinary incontinence in the frail elderly: even when it’s too late to prevent a problem, you can still slow its progress, American Journal of Nursing, Suppl, 36–46, 2003 [PubMed: 12612492] | Narrative review |
| Long, J. E., Khairat, S., Chmelo, E., Palmer, M. H., Mind over bladder: Women, aging, and bladder health, Geriatric Nursing, 39, 230–237, 2018 [PubMed: 29042069] | Study design does not meet the inclusion criteria, non-comparative study |
| MacNeill, C., Dyspareunia, Obstetrics and Gynecology Clinics of North America, 33, 565–577, 2006 [PubMed: 17116501] | Narrative review of prevalence and diagnosis |
| Manchester, J., Psychogenic urine retention: a graded approach, Nursing Mirror, 151, 48–49, 1980 | Unable to access full text article from the British Library |
| Mantle, F., Hypnosis in the treatment of enuresis, Paediatric Nursing, 11, 33–36, 1999 [PubMed: 10595167] | Narrative review of enuresis in children |
| Marti, B. G., Valentini, F. A., Robain, G., Contribution of behavioral and cognitive therapy to managing overactive bladder syndrome in women in the absence of contributive urodynamic diagnosis, International Urogynecology Journal, 26, 169–73, 2015 [PubMed: 25377294] | Narrative review |
| Maseroli, Elisa, Scavello, Irene, Rastrelli, Giulia, Limoncin, Erika, Cipriani, Sarah, Corona, Giovanni, Fambrini, Massimiliano, Magini, Angela, Jannini, Emmanuele A., Maggi, Mario, Vignozzi, Linda, Outcome of medical and psychosexual interventions for vaginismus: A systematic review and meta-analysis, Journal of Sexual Medicine, 15, 1752–1764, 2018 [PubMed: 30446469] | Systematic review, references checked for relevance (all RCTs included) |
| Maß, Reinhard, Briken, Peer, Evaluation of the Hamburg model of couple therapy in the treatment of low sexual desire and vaginismus. A prospective group comparison, Sexual & Relationship Therapy, 32, 46–57, 2017 | Study design does not meet the inclusion criteria, single arm study - no comparison group |
| McFall, Stephanie L., Yerkes, Adeline M., Cowan, Linda D., Outcomes of a small group educational intervention for urinary incontinence: Health-related quality of life, Journal of Aging and Health, 12, 301–317, 2000 [PubMed: 11067699] | Intervention does not meet the inclusion criteria, the intervention based on bladder training |
| Meadow, R., Nocturnal enuresis, Prescribers’ Journal, 35, 206–211, 1995 | Population does not meet the inclusion criteria, a narrative summary on children |
| Meek, D., Thorne, P., Luker, A., Support groups for older women, Nursing Times, 85, 71–3, 1989 [PubMed: 2616292] | Full text unavailable from the British Library |
| Miller, E., “Don’t make me laugh: comedy bursts the continence taboo”, Nursing Times, 109, 11, 2013 [PubMed: 23957123] | Study design does not meet the inclusion criteria, not a randomised controlled trail |
| Moriarty, M. B., The NIH puts the spotlight on incontinence, RNRn, 52, 44–5, 1989 [PubMed: 2734559] | Narrative summary paper |
| Morley, R., The future of SUI management … a shift in emphasis?, Health Service Journal, 114, suppl 14–5 following 54, 2004 [PubMed: 15503910] | Narrative summary paper |
| Muller, N., Continence coach: telehealth to the bladder’s rescue, Ostomy Wound Management, 59, 14, 2013 [PubMed: 24201168] | Study design does not meet the inclusion criteria, not a randomised controlled trail |
| Muller, N., Proliferating hope, Ostomy Wound Management Ostomy Wound Manage, 55, 18, 2009 [PubMed: 19603573] | Editorial |
| Ng, M. L., Vaginismus - A disease, symptom or culture-bound syndrome?, Sexual and Marital Therapy, 14, 9–13, 1999 | Commentary paper |
| Nicol, A. R., Research on psychological therapies, Current Opinion in Psychiatry, 1, 444–449, 1988 | Review, not systematic |
| Norton, C., Coping with incontinence, Geriatric Nursing & Home Care, 7, 16–9, 1987 [PubMed: 3666455] | Study design does not meet the inclusion criteria, not a randomised controlled trail |
| O’Connell, H. E., MacGregor, R. J., Russell, J. M., Female urinary incontinence. Management in primary care, Medical Journal of Australia, 157, 537–44, 1992 [PubMed: 1479975] | Study design does not meet the inclusion criteria, not a randomised controlled trail |
| Osborne, L. A., Whittall, C. M., Hanratty, H., Emanuel, R., Emery, S., Reed, P., Patient health value strength predicts compliance, but internalised health values predict outcome, in physiotherapy treatment for pelvic floor dysfunction, Physiotherapy, 102 (Supplement 1), e271, 2016 | Conference abstract |
| Osborne, Lisa A., Reed, Phil, A Review of Hypnotherapy for Overactive Bladder, International Journal of Clinical & Experimental Hypnosis, 67, 278–296, 2019 [PubMed: 31251708] | Narrative review |
| Osborne, Lisa A., Whittall, C. Mair, Emanuel, Ruth, Emery, Simon, Reed, Phil, Randomized Controlled Trial of the Effect of a Brief Telephone Support Intervention on Initial Attendance at Physiotherapy Group Sessions for Pelvic Floor Problems, Archives of Physical Medicine & Rehabilitation, 98, 2247–2252, 2017 [PubMed: 28526481] | Intervention does not meet the inclusion criteria; not a psychological intervention |
| Palsson, O. S., Heymen, S., Busby-Whitehead, J., Twist, S., Whitehead, W. E., Six-Week Internet Self-Help Intervention Reduces Symptom Episodes by 50% or More in the Majority of Individuals with Fecal Incontinence: A Pilot Study, Gastroenterology, 154 (6 Supplement 1), S-184, 2018 | Conference |
| Peters, N., Eliminate the negative, Nursing times, 95, 78, 1999 [PubMed: 10373919] | Personal experience |
| Plymat, K. R., Turner, S. L., In-home management of urinary incontinence, Home Healthcare Nurse, 6, 30–4, 1988 [PubMed: 3204031] | Commentary paper |
| Powell, M., Nurses’ hidden work, Nursing Times, 98, 53, 2002 [PubMed: 12219462] | Study design does not meet the inclusion criteria, not a randomised controlled trail |
| Rogers, J., Cognitive bladder training in the community, Paediatric Nursing, 8, 18–20, 1996 [PubMed: 9052196] | Population does not meet the inclusion criteria, children |
| Rollins, G., Behavior management improves urinary incontinence in older women living at home, Report on medical guidelines & outcomes research, 13, 7–9, 2002 [PubMed: 12440409] | Outcome data does not meet the inclusion criteria |
| Rosenbaum, Talli Y., An integrated mindfulness-based approach to the treatment of women with sexual pain and anxiety: promoting autonomy and mind/body connection, Sexual & Relationship Therapy, 28, 20–28, 2013 | Study design does not meet the inclusion criteria, not a randomised controlled trial |
| Sampselle, C. M., Behavioral interventions in young and middle-age women: simple interventions to combat a complex problem, The American journal of nursing, Suppl, 9–19, 2003 [PubMed: 12612489] | Review but no mention of psychological therapies, |
| Sampselle, C. M., Miller, J. M., Herzog, A. R., Diokno, A. C., Behavioral modification: group teaching outcomes, Urologic Nursing, 16, 59–63, 1996 [PubMed: 8826155] | Study design does not meet the inclusion criteria, not a randomised controlled study |
| Scott, M. A., Stigleman, S., What is the best hypnotic for use in the elderly?, Journal of Family Practice, 52, 976–978, 2003 [PubMed: 14653987] | Summary paper |
| Seo, J. T., Choe, J. H., Lee, W. S., Kim, K. H., Efficacy of functional electrical stimulation-biofeedback with sexual cognitive-behavioral therapy as treatment of vaginismus, Urology, 66, 77–81, 2005 [PubMed: 15992873] | Study design does not meet the inclusion criteria, not a randomised controlled trial |
| Shapiro, S. R., Enuresis: treatment and overtreatment, Pediatric nursing, 11, 203–207, 214, 1985 [PubMed: 3846878] | Population does not meet the inclusion criteria; Children |
| Shultz, J. M., Urinary incontinence, Nursing, 40, 33, 2010 [PubMed: 21079477] | Study design does not meet the inclusion criteria, not a randomised controlled study |
| Shultz, J. M., Rethink urinary incontinence in older women, Nursing, 42, 32–40; quiz p.40–1, 2012 [PubMed: 23047239] | Study design does not meet the inclusion criteria, not a randomised controlled study |
| Singh, H., Singh, D., Jain, B. K., Enuresis updated, Indian Pediatrics, 31, 611–618, 1994 [PubMed: 7875904] | Population does not meet the inclusion criteria; children |
| Stephan, E., Hajjar, R. R., Urinary incontinence in older adults, Journal Medical Libanais, 60, 220–227, 2012 [PubMed: 23461088] | Study design does not meet the inclusion criteria, not a randomised controlled study |
| Stephenson, Kyle R., Kerth, Jonathan, Effects of mindfulness-based therapies for female sexual dysfunction: A meta-analytic review, Journal of Sex Research, 54, 832–849, 2017 [PubMed: 28617103] | Systematic review, references checked for relevance, no reference to pelvic floor dysfunction |
| Stewart, M., Continence. Preparing for the future, Nursing Times, 81, 62–3, 1985 [PubMed: 3846212] | Commentary paper |
| Sudol, N. T., Garg, N., Adams-Piper, E., Jacobs, S., Lane, F. L., 56: Upgrades in patient education: Assessing the utility of an iPad application in pelvic organ prolapse comprehension and counseling satisfaction, American Journal of Obstetrics & Gynecology, 218, S928–S929, 2018 | Conference abstract |
| ter Kuile, M. M., Both, S., van Lankveld, J. J., Cognitive behavioral therapy for sexual dysfunctions in women, Psychiatric Clinics of North America, 33, 595–610, 2010 [PubMed: 20599135] | Summary of treatments paper |
| ter Kuile, Moniek, van Lankveld, Jacques J., de Groot, Ellen, Melles, Reinhilde, Neffs, Janneke, Zandbergen, Maartje, Cognitive-behavioral therapy for women with lifelong vaginismus: Process and prognostic factors, Behaviour Research and Therapy, 45, 359–373, 2007 [PubMed: 16701078] | Outcomes not usable - for outcome measures paper is comparing responders and nonresponders not intervention and control. Population the same as van Lankveld 2006. |
| Thyer, B. A., Curtis, G. C., Furosemide as an adjunct to exposure therapy of psychogenic urinary retention, Perceptual and Motor Skills, 59, 114, 1984 | No relevant outcome data |
| Vaishnav, Mrugesh, Saha, Gautam, Mukherji, Abir, Vaishnav, Parth, Principles of Marital Therapies and Behavior Therapy of Sexual Dysfunction, Indian Journal of Psychiatry, 62, S213–S222, 2020 [PMC free article: PMC7001355] [PubMed: 32055064] | Study design does not meet the inclusion criteria, not a randomised controlled study |
| Vakili, B., Chesson, R. R., Behavioral therapy for urinary incontinence and nonsurgical management of pelvic organ prolapse, Journal of Pelvic Medicine and Surgery, 11, 105–127, 2005 | Intervention does not meet the inclusion criteria |
| Walker, C. Eugene, Milling, Leonard S., Bonner, Barbara L., Incontinence disorders: Enuresis and encopresis, 363–397, 1988 | Book chapter |
| Weiss, L., Meadow, R., Group treatment for female sexual dysfunction, Arizona Medicine Ariz Med, 40, 626–8, 1983 [PubMed: 6639386] | Study design does not meet the inclusion criteria, not a randomised controlled study |
| Wolz-Beck, M., Reisenauer, C., Kolenic, G. E., Hahn, S., Brucker, S. Y., Huebner, M., Physiotherapy and behavior therapy for the treatment of overactive bladder syndrome: a prospective cohort study, Archives of Gynecology & Obstetrics, 295, 1211–1217, 2017 [PubMed: 28361203] | Intervention does not meet the inclusion criteria, not psychological maybe suitable for 11.1 |
| Wynne, H., Carty, S., Rees, J., What can be done for the elderly patient who is incontinent of urine?, Reviews in Clinical Gerontology, 7, 213–227, 1997 | Summary paper |
| Continence Promotion and Care, Nursing Times, 6-6, 2019 | Full text unavailable from the British Library |
| Norton, C., Winder, A., Continence. Target practice, Nursing Times, 89, 66, 68, 70, 1993 [PubMed: 8415105] | Full text unavailable from the British Library |
| Pottle, B., Continence. Action plans, Nursing Times, 89, 78, 1993 [PubMed: 8415107] | Full text unavailable from the British Library |
| Pottle, B., Continence. Reformed role, Nursing Times, 89, 63–4, 1993 [PubMed: 8415104] | Full text unavailable from the British Library |
| Rigby, D., Continence. Face to face support, Nursing Times, 92, 84, 1996 [PubMed: 8932163] | Full text unavailable from the British Library |
| Roja, Inara, Roja, Zenija, Use of cognitive hypnotherapy and couples therapy for female patients with psychogenic vaginismus, Contemporary Hypnosis, 27, 88–94, 2010 | Full text unavailable from the British Library |
| Rose, J., Making contact, Nursing Times, 95, 78, 81, 1999 [PubMed: 10373918] | Full text unavailable from the British Library |
| Skelton, N., Meeting the challenge, Nursing Times, 95, 82, 1999 [PubMed: 10373921] | Full text unavailable from the British Library |
| Wells, M., White, H., Continence. Self-starters, Nursing Times, 87, 64, 1991 [PubMed: 1996273] | Full text unavailable from the British Library |
| White, H., Continence. Read all about it, Nursing Times, 90, 62–4, 1994 [PubMed: 8152960] | Full text unavailable from the British Library |
Economic studies
No economic evidence was identified for this review.
Appendix L. Research recommendations
Tables
Table 1Summary of the protocol (PICO table)
| Population | Women and young women (aged 12 years and older) with symptoms associated with pelvic floor dysfunction |
|---|---|
| Intervention | Any psychological intervention, including but not exclusively those listed will be considered (examples provided below – see full list in the full protocol in appendix A):
|
| Comparison |
|
| Outcomes | Critical
|
PFMT: Pelvic floor muscle training
Table 2Summary of included studies: Psychological therapies for women with PFD or symptoms associated with PFD
| Study | Population | Intervention | Comparison | Outcomes |
|---|---|---|---|---|
|
RCT US |
N = 70 Women with chronic urogenital pain Mean age (SD) Interview group: 44.89 years (15.34) Control: 47.72 years (14.88) |
Interview n=45 (37 included in analysis) 90 minute interviews based on life stress emotional awareness and expression |
Control n=25 Treatment as usual (no further information provided) |
|
|
Feasibility RCT US |
N = 25 Postmenopa usal women with UUI Mean age (SD) |
Mindfulness-based stress reduction n=13 2 hour weekly sessions over 8 weeks. Standard protocol based on mindfulness |
Health enhancement program n=12 2 hour weekly sessions over 8 weeks. Standardised protocol based on functional movement, nutrition, physical activity and music therapy. |
|
|
RCT US | N = 22 Women with OAB (women with and without UI were included) Mean age (SD) Hypnothera py group: 51.1 years (14.0) Behavioural group: 56 years (7.4) |
Hypnotherapy n=11 Three 60 minute sessions (6–8 weeks) with a certified hypnotherapist |
Behavioural therapy n=11 Three 60 minute counselling sessions (6 to 8 weeks) |
|
|
RCT UK |
N=31 Women with PFD Mean age (SD) Motivation group: 50.33 years (11.56) Control: 49.12 years (10.76) |
Motivational interviewing n=16 20-minute group sessions delivered by a psychologist directly following sessions 2, 3, 4 of 6 PFMT sessions. The sessions targeted health behaviours, self-efficacy and autonomy, and explored ambivalence to change. |
PFMT n=15 Six, 60-minute group sessions spaced over 6 months. To train women to perform PFM exercises, to identify correct muscle groups, and to provide education on anatomy and function of PFM. |
|
OAB: Overactive bladder; PFDI-20: pelvic floor distress inventory; PFD: Pelvic floor dysfunction; PFMT: Pelvic floor muscle training; PFPT: Pelvic floor physical therapy; UUI: Urge urinary incontinence
Table 3Summary of included studies: Psychological therapy for vaginismus
| Study | Population | Intervention | Comparison | Outcomes |
|---|---|---|---|---|
|
The Netherlands RCT |
N = 70 Women with lifelong vaginismus Mean age (SD) Intervention: 28.54 years (7.83) Control: 29.29 years (6.92) |
Exposure therapy n=35 Maximum of three 2-hour sessions within the first week. Followed by two follow up over the next five weeks. Session were with a female therapist and partner. Women were exposed to self-administered penetration objects and also completed exercises at home |
Waitlist control n=35 No active treatment |
|
|
The Netherlands RCT |
N = 117 Women with lifelong vaginismus Mean age (SD) Group CBT: 28.1 years (6.0) Bibliotherapy: 29.6 years (8.8) Control: 28.2 years (5.8) |
Group CBT n=43 Ten 2 hour group sessions (6 to 9 participants) Manual based therapy including sex education, relaxation, exposure therapy, cognitive therapy, and sensate focus exercises. Included a CD-ROM and participants encouraged to practice daily |
Bibliotherapy (information) n=38 Six biweekly telephone calls of 15 minutes Waiting list control n=36 No active treatment |
|
|
Germany RCT |
N = 77 Women with vaginismus Mean age (SD) Intervention: 25.83 years (6.46) Control: 28.95 years (8.92) |
Internet based self-help n=40 Ten session of psychoeducation, relaxation, cognitive restructuring, body exposure, sensate focus exercises. Gradual insertion exercises |
Waitlist control n=37 No active treatment |
|
FSDS: Female sexual distress scale; FSFI: Female sexual function index; GRISS: Golombok Rust inventory for sexual satisfaction; SDQ: Sexual disgust questionnaire;
Final
Evidence review underpinning recommendations 1.6.28, 1.6.29 and a research recommendation in the NICE guideline
These evidence reviews were developed by the National Guideline Alliance which is a part of the Royal College of Obstetricians and Gynaecologists
Disclaimer: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.
NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the Welsh Government, Scottish Government, and Northern Ireland Executive. All NICE guidance is subject to regular review and may be updated or withdrawn.