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Heart rate variability dynamics in women with urinary incontinence: a systematic review

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Abstract

Introduction and hypothesis

Sympathetic and parasympathetic pathways of the autonomic nervous system (ANS) regulate the lower urinary tract. The aim of the present study was to synthesize the evidence regarding ANS regulation in women with urinary incontinence (UI) evaluated through heart rate variability (HRV).

Methods

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Five databases were researched in April 2021 (PubMed, CINHAL, Scopus, Web of Science and Cochrane Library) and included cross-sectional studies in full-length publications in the English language. Studies assessed the HRV during bladder filling (group A) and after voiding (group B). The Joanna Briggs Institute (JBI) checklist was applied for methodological quality assessment purposes.

Results

A total of 920 articles were identified and 5 studies were included. Most studies analyzed the HRV by linear indexes. Studies from group A (n = 2) presented fair methodological quality; one study from group B (n = 3) showed fair methodological quality (Im et al. Korean J Urol. 51:183, 2010) whereas the others presented high methodological quality. One study from group A found an increase in both modulations between women with overactive bladder (OAB) versus women with stress UI, whereas a decrease was reported between incontinent and continent women. Studies from group B showed a decreased sympathetic and parasympathetic modulation in AOB with detrusor overactivity (DO), whereas one study found an increase in both modulations in women with OAB compared with stress UI.

Conclusion

Parasympathetic and sympathetic modulation increased during bladder filling and rest in UI with OAB associated or not with DO. Both modulations decreased during bladder filling in incontinent women and during rest in OAB.

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Funding

This study was financed in part by Coordination for the Improvement of Higher Education Personnel, Finance Code 001.

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Authors and Affiliations

  1. Physical Therapy Department, Women’s Health Research Laboratory, Rodovia Washington Luís, km 235, Monjolinho, São Carlos, SP, 13565-905, Brazil

    Jordana Barbosa da Silva, Juliana Falcão Padilha & Patricia Driusso

  2. Physical Therapy Department, São Carlos, Cardiovascular Physical Therapy Laboratory, Rodovia Washington Luís, km 235, Monjolinho, São Carlos, SP, 13565-905, Brazil

    Raphael Martins de Abreu & Aparecida Maria Catai

  3. Physical Therapy Department, Cardiopulmonary Physical Therapy Laboratory, São Carlos, Rodovia Washington Luís, km 235, Monjolinho, São Carlos, SP, 13565-905, Brazil

    Audrey Borghi-Silva

Authors
  1. Jordana Barbosa da Silva
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  2. Raphael Martins de Abreu
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  3. Juliana Falcão Padilha
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  4. Audrey Borghi-Silva
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  5. Aparecida Maria Catai
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  6. Patricia Driusso
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Contributions

J.B.S., R.M.A.: substantial contributions to conception and design; drafting and revising the article critically for important intellectual content; final approval of the version to be published; J.F.P., A.B.S., .A.M.C., P.D.: substantial contributions to conception and design; final approval of the version to be published.

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Correspondence to Jordana Barbosa da Silva.

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da Silva, J.B., de Abreu, R.M., Padilha, J.F. et al. Heart rate variability dynamics in women with urinary incontinence: a systematic review. Int Urogynecol J 33, 1145–1155 (2022). https://doi.org/10.1007/s00192-021-05060-x

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  • DOI: https://doi.org/10.1007/s00192-021-05060-x

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