PROSPERO International prospective register of systematic reviews Long-term impact of delivery mode on stress urinary incontinence and urgency urinary incontinence Riikka M. Tähtinen, Rufus Cartwright, Kari A. O. Tikkinen, Gordon H Guyatt, Diane Heels-Ansdell, Yoshitaka Aoki, Johnson F Tsui, Riikka L Aaltonen, Jovita L Cárdenas, Regina El Dib, Kirsi M Joronen, Sumayyah Al Juaid, Sabreen Kalantan, Michal Kochana, Malgorzata Kopec, Luciane C Lopes, Enaya Mirza, Sanna M Oksjoki, Jori S Pesonen, Antti Valpas, Li Wang, Yuqing Zhang Citation Riikka M. Tähtinen, Rufus Cartwright, Kari A. O. Tikkinen, Gordon H Guyatt, Diane Heels-Ansdell, Yoshitaka Aoki, Johnson F Tsui, Riikka L Aaltonen, Jovita L Cárdenas, Regina El Dib, Kirsi M Joronen, Sumayyah Al Juaid, Sabreen Kalantan, Michal Kochana, Malgorzata Kopec, Luciane C Lopes, Enaya Mirza, Sanna M Oksjoki, Jori S Pesonen, Antti Valpas, Li Wang, Yuqing Zhang. Long-term impact of delivery mode on stress urinary incontinence and urgency urinary incontinence. PROSPERO 2013:CRD42013006213 Available from http://www.crd.york.ac.uk/prospero_rebranding/display_record.asp?id=crd42013006213 Review question(s) What is the impact of delivery mode on the risk of stress urinary incontinence and urgency urinary incontinence in the long term. Specifically, what is the risk of each subtype of incontinence, comparing emergency and elective caesarean, comparing operative and spontaneous vaginal delivery, and comparing elective caesarean and all other delivery modes. Searches We will search MEDLINE, SCOPUS and CINAHL up to end of October 2014. We will not apply restrictions to language of publication. We will search abstracts published in the annual meetings of the International Continence Society (ICS) and the International Urogynecological Association (IUGA) (years 1999-2014). Types of study to be included Any cross-sectional, prospective or retrospective study that records relevant UI and mode of delivery outcomes from more than one year post delivery onwards. Cross-sectional studies that include women in the first postpartum year are also acceptable, provided they represent <95% of the population, or subgroup analysis is possible. Condition or domain being studied Stress urinary incontinence (complaint of involuntary loss of urine on effort or physical exertion) and urgency urinary incontinence (complaint of involuntary loss of urine associated with urgency). Long term impact of delivery mode (including spontaneous vaginal, caesarean, and operative vaginal) on stress urinary incontinence and urgency urinary incontinence. Participants/ population Studies with population or community based samples of women (no age restriction) are eligible. Furthermore, prospective longitudinal studies with secondary care (hospital based) samples are eligible provided recruitment occurs in the perinatal period, and the sample is demonstrably population representative. Both prospective and not prospective (retrospective and cross-sectional) studies are eligible (if demonstrably population representative). Intervention(s), exposure(s) Modes of delivery include spontaneous vaginal delivery, forceps, vacuum, pre-labour caesarean, early labour caesarean, and/or late labour caesarean. Assessment methods of delivery mode include self-reporting, hospital records, linkage to validated database. Other relevant outcomes include BMI, parity and age at delivery. Comparator(s)/ control See above Page: 1 / 5
Outcome(s) Primary outcomes Stress urinary incontinence and urgency urinary incontinence. Secondary outcomes None. Data extraction, (selection and coding) The search described above will be used to select abstracts for screening. We will develop piloted, standardized data forms for this study. Two methodologically trained reviewers will apply these forms, guided with written instructions, to screen searched study reports for eligibility, and extract data from eligible reports, independently and in duplicate. The reviewers will conduct pilot screening and data extraction exercises to achieve a high level of consensus. We will screen titles and abstracts to select papers for full-text assessment. All screening will be in duplicate. Then, we will screen full text papers to confirm eligibility of the articles. All data extraction will again be in duplicate. Reviewers will resolve any disagreement through discussions, and any remaining will be discussed with one of two adjudicators. Data to be extracted: Study ID number, last name of the first author, is there overlap data from another study, study title, Study type, year of the publication, country, source of funding, sample size, number of analyzed participants (SUI/UUI), respond proportion at baseline, respond proportion at follow up, follow up time (minimum, maximum, median/mean), age of the study population (minimum, maximum, median/mean specific question used to identify SUI/UUI, specify source of this question Does the group of women identified as "stress incontinent" potentially include also women with urge incontinence (i.e. mixed incontinence)?/ Does the group of women identified as "urge incontinent" potentially include also women with stress incontinence (i.e. mixed incontinence)? Severity assessments SUI/UUI Delivery Information: Adjusted OR s, 95% Confidence intervals, adjusting factors for different delivery modes (Any vaginal, spontaneous vaginal, instrumental delivery, vacuum, forceps, caesarean, elective caesarean, emergency caesarean, other) separately for SUI and UUI Risk of bias (quality) assessment We use modified Cochrane risk of bias tool to assess risk of bias and Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to evaluate quality of evidence." Strategy for data synthesis A quantitative synthesis is planned, including random effects meta-analysis of the primary outcome, with metaregression for modifying risks. Analysis of subgroups or subsets None planned. Contact details for further information Riikka Tähtinen Riikka Tähtinen Obstetrics and Gynekology, Kuopio University Hospital, PL 100, Page: 2 / 5
70029 KYS rm.tahtinen@gmail.com Organisational affiliation of the review None None Review team Dr Riikka M. Tähtinen, Kuopio University Hospital, Kuopio Dr Rufus Cartwright, Dept. of Epidemiology and Biostatistics, Imperial College London, UK and Dept. of Urogynaecology, Imperial College London, UK Dr Kari A. O. Tikkinen, Dept. of Urology, Helsinki University Central Hospital and University of Helsinki, Helsinki, and Dept. of Clinical Epidemiology and Biostatistics, Hamilton, ON, Canada Professor Gordon H Guyatt, Dept. of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada Mrs Diane Heels-Ansdell, Dept. of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada Dr Yoshitaka Aoki, Dept. of Urology, University of Fukui Faculty of Medical Sciences, Fukui, Japan Dr Johnson F Tsui, Department of Urology, North Shore-LIJ Lenox Hill Hospital, New York City, NY, USA Dr Riikka L Aaltonen, Dept. of Obstetrics and Gynaecology, University of Turku and Turku University Hospital, Turku, Dr Jovita L Cárdenas, Dept. of Clinical Practice Guidelines, National Center for Health Technology Excellence, México, Mexico Dr Regina El Dib, Dept. of Anaesthesiology, Botucatu Medical School, São Paulo State University, São Paulo, Brazil Dr Kirsi M Joronen, Dept. of Obstetrics and Gynaecology, University of Turku and Turku University Hospital, Turku, Dr Sumayyah Al Juaid, Dept. of Obstetrics and Gynaecology, King Saud bin Abdulaziz University for Health Sciences, and King AbdulAziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia Dr Sabreen Kalantan, Dept. of Obstetrics and Gynaecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia Mr Michal Kochana, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland Ms Malgorzata Kopec, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland Professor Luciane C Lopes, School of Pharmaceutical Sciences, Department of Drugs and Medications, São Paulo State University, Araraquara, São Paulo, Brazil Dr Enaya Mirza, Dept. of Obstetrics and Gynaecology, St Marys Hospital, London, UK Dr Sanna M Oksjoki, Dept. of Obstetrics and Gynaecology, University of Turku and Turku University Hospital, Turku, Dr Jori S Pesonen, Dept. of Urology, Päijät-Häme Central Hospital, Lahti, Dr Antti Valpas, Dept. of Obstetrics and Gynaecology, South-Karelian Central Hospital, Lappeenranta, Dr Li Wang, Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON, Canada Yuqing Zhang, Dept. of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada Anticipated or actual start date 03 September 2012 Anticipated completion date 01 May 2015 Funding sources/sponsors Academy of, Jane and Aatos Erkko Foundation, Sigrid Jusélius Foundation, Competitive Research Fundings of the Helsinki and Uusimaa Hospital District, South Karelian Social and Welfare District, Kanta-Häme Central Page: 3 / 5
Hospital and Pohjois-Savo Health Care District. Conflicts of interest None known Language English Country Subject index terms status Subject indexing assigned by CRD Subject index terms Delivery, Obstetric; Humans; Urinary Incontinence, Urge; Urinary Incontinence, Stress Reference and/or URL for protocol Tähtinen RM, Cartwright R, Tsui JF, Aaltonen RL, Aoki Y, Cárdenas JL, El Dib R, Joronen KM, Al Juaid S, Kalantan S, Kochana M, Kopec M, Lopes LC, Mirza E, Oksjoki SM, Pesonen JS, Valpas A, Wang L, Zhang Y, Heels-Ansdell D, Guyatt GH, Tikkinen KA. Long-term Impact of Mode of Delivery on Stress Urinary Incontinence and Urgency Urinary Incontinence: A Systematic Review and Meta-analysis. Eur Urol. 2016 Jul;70(1) Stage of review Completed and published Date of registration in PROSPERO 18 November 2013 Date of publication of this revision 12 January 2017 Details of final report/publication(s) Tähtinen RM, Cartwright R, Tsui JF, Aaltonen RL, Aoki Y, Cárdenas JL, El Dib R, Joronen KM, Al Juaid S, Kalantan S, Kochana M, Kopec M, Lopes LC, Mirza E, Oksjoki SM, Pesonen JS, Valpas A, Wang L, Zhang Y, Heels-Ansdell D, Guyatt GH, Tikkinen KA. Long-term Impact of Mode of Delivery on Stress Urinary Incontinence and Urgency Urinary Incontinence: A Systematic Review and Meta-analysis. Eur Urol. 2016 Jul;70(1) http://www.europeanurology.com/article/s0302-2838(16)00156-1/fulltext/long-term-impact-of-mode-of-delivery-onstress-urinary-incontinence-and-urgency-urinary-incontinence-a-systematic-review-and-meta-analysis DOI 10.15124/CRD42013006213 Stage of review at time of this submission Started Completed Preliminary searches Yes Yes Piloting of the study selection process Yes Yes Formal screening of search results against eligibility criteria Yes Yes Data extraction Yes Yes Risk of bias (quality) assessment Yes Yes Data analysis Yes Yes PROSPERO Page: 4 / 5
Powered by TCPDF (www.tcpdf.org) International prospective register of systematic reviews The information in this record has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Page: 5 / 5