Skip to main content

Advertisement

Log in

Mobile technologies for the conservative self-management of urinary incontinence: a systematic scoping review

  • Review Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

The objective was to appraise the current use of mobile technologies for the conservative self-management of urinary incontinence (UI). Moreover, we aimed to explore whether they integrate recommended features for the use of mobile technologies in healthcare and recognized parameters for optimal conservative UI treatment.

Methods

We conducted a literature search on Medline, Embase, CINAHL, REHABDATA, Cochrane Library and PEDro databases. Eligible articles included people with UI of any type and use of a mobile technology for the conservative self-management of UI. Two reviewers independently screened, reviewed, and extracted data on study design, type of mobile technologies, valuable features, and outcomes related to UI.

Results

Twelve articles (level of evidence II to V) were retained. Technologies used were a mobile app alone (n = 2), a Pelvic Floor Muscle Training (PFMT) device and app (n = 2), a PFMT device and telerehabilitation (n = 1), a smartphone messaging system (n = 1), and an internet-based program (n = 1). PFMT programs prescribed a daily frequency for at least 8 weeks. Between 1 and 4 valuable features were reported out of 6 identified. After intervention, at least 1 outcome on UI severity was reported improved in 6/7 studies, satisfaction was high in 3/3 studies and adherence was high (daily usage) in 4/5 studies.

Conclusion

There is level 2 evidence that there are benefits of using mobile technologies in terms of improvements in UI, satisfaction, adherence, and costs. Mobile technologies reviewed seem to follow optimal PFMT parameters, but users could benefit further from more built-in features that may optimize rehabilitation outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Abrams P, Cardozo L, Wagg A, Wein A. Incontinence. 6th edition. ICI-ICS. Bristol: International Continence Society; 2017.

  2. Herschorn S, Gajewski J, Schulz J, Corcos J. A population-based study of urinary symptoms and incontinence: the Canadian urinary bladder survey. BJU Int. 2008;101(1):52–8. https://doi.org/10.1111/j.1464-410X.2007.07198.x.

    Article  PubMed  Google Scholar 

  3. Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006;50(6):1306–14. https://doi.org/10.1016/j.eururo.2006.09.019. discussion 1314-1305.

    Article  PubMed  Google Scholar 

  4. Esparza AO, Tomas MAC, Pina-Roche F. Experiences of women and men living with urinary incontinence: a phenomenological study. Appl Nurs Res. 2018;40:68–75. https://doi.org/10.1016/j.apnr.2017.12.007.

    Article  PubMed  Google Scholar 

  5. Abrams P, Smith AP, Cotterill N. The impact of urinary incontinence on health-related quality of life (HRQoL) in a real-world population of women aged 45-60 years: results from a survey in France, Germany, the UK and the USA. BJU Int. 2015;115(1):143–52. https://doi.org/10.1111/bju.12852.

    Article  PubMed  Google Scholar 

  6. Ramage-Morin PL, Gilmour H. Incontinence urinaire et solitude chez les personnes âgées au Canada. Statistique Canada, Rapports sur la santé 82-003-X, vol. 24; 2013. p. 10.

  7. Corcos J, Przydacz M, Campeau L, Gray G, Hickling D, Honeine C, et al. CUA guideline on adult overactive bladder. Can Urol Assoc J. 2017;11(5):E142–E173. https://doi.org/10.5489/cuaj.4586.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Bettez M, Tu le M, Carlson K, Corcos J, Gajewski J, Jolivet M, et al. 2012 update: guidelines for adult urinary incontinence collaborative consensus document for the Canadian Urological Association. Can Urol Assoc J. 2012;6(5):354–63. https://doi.org/10.5489/cuaj.12248.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018;10:CD005654. https://doi.org/10.1002/14651858.CD005654.pub4.

    Article  Google Scholar 

  10. Deslauriers S, Raymond MH, Laliberte M, Lavoie A, Desmeules F, Feldman DE, et al. Access to publicly funded outpatient physiotherapy services in Quebec: waiting lists and management strategies. Disabil Rehabil. 2017;39(26):2648–56. https://doi.org/10.1080/09638288.2016.1238967.

    Article  PubMed  Google Scholar 

  11. Kelly AM, Jordan F. Empowering patients to self-manage in the context of incontinence. Br J Nurs. 2015;24(14):726–30.

    Article  PubMed  Google Scholar 

  12. Mansell G, Hall A, Toomey E. Behaviour change and self-management interventions in persistent low back pain. Best Pract Res Clin Rheumatol. 2016;30(6):994–1002. https://doi.org/10.1016/j.berh.2017.07.004.

    Article  PubMed  Google Scholar 

  13. Nasi G, Cucciniello M, Guerrazzi C. The role of mobile technologies in health care processes: the case of cancer supportive care. J Med Internet Res. 2015;17(2):e26. https://doi.org/10.2196/jmir.3757.

    Article  PubMed  PubMed Central  Google Scholar 

  14. National Institute for Health Care and Excellence. Behaviour change: general approaches. London: NICE; 2007.

    Google Scholar 

  15. Nussbaum R, Kelly C, Quinby E, Mac A, Parmanto B, Dicianno BE. A systematic review of mobile health applications in rehabilitation. Arch Phys Med Rehabil. 2019;100(1):115–27. https://doi.org/10.1016/j.apmr.2018.07.439.

    Article  PubMed  Google Scholar 

  16. Cumming TM, Draper Rodríguez C. A meta-analysis of Mobile technology supporting individuals with disabilities. J Spec Educ. 2017;51(3):164–76. https://doi.org/10.1177/0022466917713983.

    Article  Google Scholar 

  17. Mobile Technology. Cambridge dictionary. Cambridge: Cambridge University Press; 2018. www.cambridge.org

  18. Intelligence M. North America Mobile Health Market—segmented by monitoring and diagnostic medical device and services, Mobile Healthcare Apps, by services and by geography—growth, trends and forecast. Hyderabad: Intelligence M; 2016.

  19. Barnes KL, Dunivan G, Jaramillo-Huff A, Krantz T, Thompson J, Jeppson P. Evaluation of smartphone pelvic floor exercise applications using standardized scoring system. Female Pelvic Med Reconstr Surg. 2018. https://doi.org/10.1097/spv.0000000000000563.

    Article  Google Scholar 

  20. Mendiola MF, Kalnicki M, Lindenauer S. Valuable features in mobile health apps for patients and consumers: content analysis of apps and user ratings. JMIR mHealth uHealth. 2015;3(2):e40. https://doi.org/10.2196/mhealth.4283.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Peters M, Godfrey C, McInerney P, Soares C, Khalil H, Parker D. The Joanna Briggs Institute reviewers’ manual 2015: methodology for JBI scoping reviews. Adelaide: Joanna Briggs Institute. 2015.

    Google Scholar 

  22. Free C, Phillips G, Watson L, Galli L, Felix L, Edwards P, et al. The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS Med. 2013;10(1):e1001363. https://doi.org/10.1371/journal.pmed.1001363.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Keng S, Zixing S. Mobile healthcare informatics. Med Inform Internet Med. 2006;31(2):89–99. https://doi.org/10.1080/14639230500095651.

    Article  Google Scholar 

  24. Payne HE, Lister C, West JH, Bernhardt JM. Behavioral functionality of mobile apps in health interventions: a systematic review of the literature. JMIR mHealth uHealth. 2015;3(1):e20. https://doi.org/10.2196/mhealth.3335.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Hay-Smith EJ, Herderschee R, Dumoulin C, Herbison GP. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev. 2011;12:CD009508. https://doi.org/10.1002/14651858.CD009508.

    Article  Google Scholar 

  26. Dumoulin C, Adewuyi T, Booth J, Bradley C, Burgio K, Hagen S, et al. Adult conservative management. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. Paris: Health Publication Ltd; 2017. p. 1443–742.

    Google Scholar 

  27. National Institute for Health Care and Excellence. Urinary incontinence in women: management. London: NICE; 2013 (updated 2015).

  28. OCEBM Levels of Evidence Working Group. The Oxford Levels of Evidence 2. Oxford Centre for Evidence-Based Medicine.

  29. Asklund I, Nyström E, Sjöström M, Umefjord G, Stenlund H, Samuelsson E. Mobile app for treatment of stress urinary incontinence: a randomized controlled trial. Neurourol Urodyn. 2017;36(5):1369–76. https://doi.org/10.1002/nau.23116.

    Article  PubMed  Google Scholar 

  30. Hoffman V, Soderstrom L, Samuelsson E. Self-management of stress urinary incontinence via a mobile app: two-year follow-up of a randomized controlled trial. Acta Obstet Gynecol Scand. 2017;96(10):1180–7. https://doi.org/10.1111/aogs.13192.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Nyström E, Asklund I, Sjöström M, Stenlund H, Samuelsson E. Treatment of stress urinary incontinence with a mobile app: factors associated with success. Int Urogynecol J. 2018;29(9):1325–33. https://doi.org/10.1007/s00192-017-3514-1.

    Article  PubMed  Google Scholar 

  32. Sjöström M, Lindholm L, Samuelsson E. Mobile app for treatment of stress urinary incontinence: a cost-effectiveness analysis. J Med Internet Res. 2017;19(5):e154. https://doi.org/10.2196/jmir.7383.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Carrión Pérez F, Rodríguez Moreno MS, Carnerero Córdoba L, Romero Garrido MC, Quintana Tirado L, García Montes I. [Telerehabilitation to treat stress urinary incontinence. Pilot study]. Med Clin. 2015;144(10):445–8. https://doi.org/10.1016/j.medcli.2014.05.036.

    Article  Google Scholar 

  34. Kinouchi K, Ohashi K. Smartphone-based reminder system to promote pelvic floor muscle training for the management of postnatal urinary incontinence: historical control study with propensity score-matched analysis. PeerJ. 2018;6:e4372. https://doi.org/10.7717/peerj.4372.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Pepper J, Zhang A, Li R, Wang XH. Usage results of a mobile app for managing urinary incontinence. J Urol. 2015;193(4):1292–7. https://doi.org/10.1016/j.juro.2014.10.009.

    Article  PubMed  Google Scholar 

  36. Shelly B. Pelvic muscle exercises using a home trainer for pelvic muscle dysfunction: a case report. Urol Nurs. 2016;36(2):82–7.

    Article  PubMed  Google Scholar 

  37. Sjöström M, Umefjord G, Lindholm L, Samuelsson E. Cost-effectiveness of an internet-based treatment program for stress urinary incontinence. Neurourol Urodyn. 2015;34(3):244–50. https://doi.org/10.1002/nau.22540.

    Article  PubMed  Google Scholar 

  38. Sjöström 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 Int. 2013;112(3):362–72. https://doi.org/10.1111/j.1464-410X.2012.11713.x.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Sjöström 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 Int. 2015;116(6):955–64. https://doi.org/10.1111/bju.13091.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Starr JA, Drobnis EZ, Cornelius C. Pelvic floor biofeedback via a smart phone app for treatment of stress urinary incontinence. Urol Nurs. 2016;36(2):88–91. 97.

    Article  PubMed  Google Scholar 

  41. Jahan S. Human development indices and indicators. Washington DC: United Nations Development Programme, Communications Development Incorporated; 2018.

    Google Scholar 

  42. Latorre GFS, de Fraga R, Seleme MR, Mueller CV, Berghmans B. An ideal e-health system for pelvic floor muscle training adherence: systematic review. Neurourol Urodyn. 2019;38(1):63–80. https://doi.org/10.1002/nau.23835.

    Article  PubMed  Google Scholar 

  43. Badawy SM, Barrera L, Sinno MG, Kaviany S, O’Dwyer LC, Kuhns LM. Text messaging and Mobile phone apps as interventions to improve adherence in adolescents with chronic health conditions: a systematic review. JMIR mHealth uHealth. 2017;5(5):e66. https://doi.org/10.2196/mhealth.7798.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Mayes J, White A. How smartphone technology is changing healthcare in developing countries. J Glob Health. 2016; http://www.ghjournalorg/how-smartphone-technology-is-changing-healthcare-in-developing-countries.

  45. Kay M, Santos J, Takane M. mHealth: new horizons for health through mobile technologies. World Health Organization. 2011;64(7):66–71.

    Google Scholar 

  46. Krishna S, Boren SA, Balas EA. Healthcare via cell phones: a systematic review. Telemed J E Health. 2009;15(3):231–40.

    Article  PubMed  Google Scholar 

  47. Goršič M, Cikajlo I, Novak D. Competitive and cooperative arm rehabilitation games played by a patient and unimpaired person: effects on motivation and exercise intensity. J Neuroeng Rehabil. 2017;14(1):23.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Argent R, Daly A, Caulfield B. Patient involvement with home-based exercise programs: can connected health interventions influence adherence? JMIR mHealth uHealth. 2018;6(3):e47. https://doi.org/10.2196/mhealth.8518.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Dumoulin C, Glazener C, Jenkinson D. Determining the optimal pelvic floor muscle training regimen for women with stress urinary incontinence. Neurourol Urodyn. 2011;30(5):746–53. https://doi.org/10.1002/nau.21104.

    Article  PubMed  Google Scholar 

  50. Hay-Smith J, Herderschee R, Dumoulin C, Herbison P. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women: an abridged Cochrane systematic review. Eur J Phys Rehabil Med. 2012;48(4):689–705.

    CAS  PubMed  Google Scholar 

  51. Wilson K. Mobile cell phone technology puts the future of health care in our hands. Can Med Assoc J. 2018;190(13):E378–9.

    Article  Google Scholar 

  52. Canadian Medical Association. Introduction à l’avenir de la technologie en matière de santé et de soins de santé. Sommet sur la santé: document contextuel; 2018.

  53. DiFilippo KN, Huang WH, Andrade JE, Chapman-Novakofski KM. The use of mobile apps to improve nutrition outcomes: a systematic literature review. J Telemed Telecare. 2015;21(5):243–53. https://doi.org/10.1177/1357633x15572203.

    Article  PubMed  Google Scholar 

  54. Flores Mateo G, Granado-Font E, Ferré-Grau C, Montaña-Carreras X. Mobile phone apps to promote weight loss and increase physical activity: a systematic review and meta-analysis. J Med Internet Res. 2015;17(11):e253. https://doi.org/10.2196/jmir.4836.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Overdijkink SB, Velu AV, Rosman AN, van Beukering MD, Kok M, Steegers-Theunissen RP. The usability and effectiveness of Mobile health technology-based lifestyle and medical intervention apps supporting health care during pregnancy: systematic review. JMIR mHealth uHealth. 2018;6(4):e109. https://doi.org/10.2196/mhealth.8834.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Stephanie Bernard is supported by the Fonds de recherche du Québec – Santé (FRQ-S).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hélène Moffet.

Ethics declarations

Conflicts of interest

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bernard, S., Boucher, S., McLean, L. et al. Mobile technologies for the conservative self-management of urinary incontinence: a systematic scoping review. Int Urogynecol J 31, 1163–1174 (2020). https://doi.org/10.1007/s00192-019-04012-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-019-04012-w

Keywords

Navigation