Abstract:
BACKGROUND:Pelvic organ prolapse is common, and some degree of prolapse is seen in 50% of parous women. Women with prolapse can experience a variety of pelvic floor symptoms. Treatments include surgery, mechanical devices and conservative management. Conservative management approaches, such as giving lifestyle advice and delivering pelvic floor muscle training, are often used in cases of mild to moderate prolapse. OBJECTIVES:To determine the effects of conservative management (physical interventions and lifestyle interventions) for women with pelvic organ prolapse in comparison with no treatment or other treatment options (such as mechanical devices or surgery). SEARCH STRATEGY:We searched the Cochrane Incontinence Group Specialised Trials Register (searched on 19 September 2005), MEDLINE (January 1966 to August 2005), MEDLINE In Process & Other Citations (15 September 2005), EMBASE (January 1996 to Week 43 2005), CINAHL (January 1982 to October 2005), PEDro (September 2005), the UK National Research Register (Issue 3, 2005), the US National Institute of Health clinical trial register (5 October 2005), Current Controlled Trials register (5 October 2005), Controlled Clinical Trials (September 2005) and ZETOC (September 2005). We searched the reference lists of relevant articles. SELECTION CRITERIA:Randomised and quasi-randomised trials in women with pelvic organ prolapse that included a physical or lifestyle intervention in at least one arm of the trial. DATA COLLECTION AND ANALYSIS:Two reviewers assessed all trials for inclusion/exclusion and methodological quality. Data were extracted by the lead reviewer onto a standard form and cross checked by another. Disagreements were resolved by discussion. Data were processed as described in the Cochrane Handbook for Systematic Reviews of Interventions. MAIN RESULTS:Three trials of relevance to this review were identified. The largest of these, of pelvic floor muscle training in preventing anterior prolapse from worsening, had significant limitations which affect the generalisability and rigor of the findings. A small feasibility study (which is to be followed up with a larger trial) randomised 47 women to pelvic floor muscle training or control and found suggestions of better outcomes (better self-reported improvement, decreased severity) in the intervention group. The third trial evaluated peri-operative physiotherapy for women undergoing surgery for prolapse and/or incontinence. The authors report that urinary symptoms, pelvic floor muscle function and quality of life were improved more in the treatment group than the control group, but data were not provided to allow this to be assessed. The trial was small and no prolapse-specific outcome measures were used. It was not possible to combine data from the three trials. AUTHORS' CONCLUSIONS:Despite there now being reports of three eligible trials in this update, the evidence available is not significant to guide practice. There is some encouragement from a feasibility study that pelvic floor muscle training, delivered by a physiotherapist to symptomatic women in an outpatient setting, may reduce severity of prolapse. Further evidence from larger, better quality randomised control trials is however still necessary.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Hagen S,Stark D,Maher C,Adams Edoi
10.1002/14651858.CD003882.pub3subject
Has Abstractpub_date
2006-10-18 00:00:00pages
CD003882issue
4issn
1469-493Xpub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Recurrent respiratory papillomatosis is a condition characterised by benign papillomatous (wart-like) growths in the upper airway. It can affect both adults and children causing airway-obstruction and voice change. Treatment usually involves repeated surgical debulking of the papillomata, and several agents ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD005053.pub2
更新日期:2005-10-19 00:00:00
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD002000
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abstract:BACKGROUND:Quetiapine is a novel atypical antipsychotic with low propensity for movement disorder adverse effects. It is used for treatment of schizophrenia and other psychoses. OBJECTIVES:To determine the effects of quetiapine for schizophrenia in comparison to placebo, classical and other atypical antipsychotics. S...
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doi:10.1002/14651858.CD000967
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD006894.pub2
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doi:10.1002/14651858.CD000964.pub2
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doi:10.1002/14651858.CD002253.pub4
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doi:10.1002/14651858.CD008000.pub2
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD011240.pub2
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doi:10.1002/14651858.CD004226.pub3
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pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005041.pub2
更新日期:2014-09-18 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD001554
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Neural tube defects arise during the development of the brain and spinal cord. OBJECTIVES:The objective of this review was to assess the effects of increased consumption of folate or multivitamins on the prevalence of neural tube defects periconceptionally (that is before pregnancy and in the first two mont...
journal_title:The Cochrane database of systematic reviews
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更新日期:2011-04-13 00:00:00
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD001904
更新日期:2003-01-01 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD002919.pub2
更新日期:2005-07-20 00:00:00
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pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD010336.pub2
更新日期:2015-06-04 00:00:00
abstract:BACKGROUND:Social phobia (SP), or social anxiety disorder, is a prevalent and disabling disorder. There is growing evidence that SP is mediated by specific neurobiological factors, and increased interest in the use of medication in its treatment. OBJECTIVES:To assess the effects of pharmacotherapy for Social Phobia, a...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD001206.pub2
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abstract:BACKGROUND:An abdominal aortic aneurysm (AAA) is the pathological enlargement of the aorta and can develop in both men and women. Progressive aneurysm enlargement can lead to rupture. The rupture of an AAA is frequently fatal and accounts for the death from haemorrhagic shock of at least 45 people per 100,000 populatio...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD011664.pub3
更新日期:2018-06-13 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005473.pub2
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pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD008816.pub4
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abstract:BACKGROUND:Many dental procedures cause bacteraemia and it is believed that this may lead to bacterial endocarditis (BE) in a few people. Guidelines in many countries recommend that prior to invasive dental procedures antibiotics are administered to people at high risk of endocarditis. However, it is unclear whether th...
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pub_type: 杂志文章,评审
doi:10.1002/14651858.CD003813.pub2
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doi:10.1002/14651858.CD000023.pub2
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Preterm infants experience a range of morbidity related to the immaturity of their organ systems and to concurrent disease states. An unfavourable environment in the neonatal intensive care unit (NICU) may compound this morbidity. Modification of the environment could minimize the iatrogenic effects. Develop...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
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更新日期:2000-01-01 00:00:00
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD004651.pub3
更新日期:2007-07-18 00:00:00
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pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004728.pub2
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journal_title:The Cochrane database of systematic reviews
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abstract:BACKGROUND:Prostate cancer is a common cause of death in developed countries, yet the benefits of screening for prostate cancer still remain controversial. A prostate-specific antigen (PSA) test result greater than 4 ng/mL (nanograms/millilitre) has commonly been used as the cut-off level for seeking further tests to d...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
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abstract:BACKGROUND:The conventional method of induction of labour is with intravenous oxytocin. More recently, induction with prostaglandins, followed by an infusion of oxytocin if necessary, has been used. OBJECTIVES:The objective of this review was to assess the effects of induction of labour with prostaglandins compared wi...
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更新日期:2000-01-01 00:00:00