***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The aim was to compare effectiveness of group versus individual sessions of physiotherapy in terms of symptoms , quality of life , and costs , and to investigate the effect of patient preference on uptake and outcome of treatment . Methods A pragmatic , multi-centre r and omised controlled trial in five British National Health Service physiotherapy departments . 174 women with stress and /or urge incontinence were r and omised to receive treatment from a physiotherapist delivered in a group or individual setting over three weekly sessions . Outcome were measured as Symptom Severity Index ; Incontinence-related Quality of Life question naire ; National Health Service costs , and out of pocket expenses . Results The majority of women expressed no preference ( 55 % ) or preference for individual treatment ( 36 % ) . Treatment attendance was good , with similar attendance with both service delivery models . Overall , there were no statistically significant differences in symptom severity or quality of life outcomes between the models . Over 85 % of women reported a subjective benefit of treatment , with a slightly higher rating in the individual compared with the group setting . When all health care costs were considered , average cost per patient was lower for group sessions ( Mean cost difference £ 52.91 95 % , confidence interval ( £ 25.82 - £ 80.00 ) ) . Conclusion Indications are that whilst some women may have an initial preference for individual treatment , there are no substantial differences in the symptom , quality of life outcomes or non-attendance . Because of the significant difference in mean cost , group treatment is recommended . Trial Registration Trial Registration number : IS RCT N PURPOSE to compare the effects of functional electrostimulation of the pelvic floor and therapy with cones in women with stress urinary incontinence ( SUI ) . METHODS r and omized clinical study for which 45 patients with SUI were selected . The effects of functional electrostimulation of the pelvic floor were evaluated in the SUI treatment of 24 women , with the use of clinical data ( micturition diary , pad test and a question naire about quality of life - I-QoL ) . The patients were su bmi tted to two 20 ' weekly sessions for four consecutive months , under the supervision of a physiotherapist . The electrode used had 10 cm length and 3.5 cm width with a double metallic ring and a cylindrical shape , positioned in the medium third of the vagina . The electric parameters used were : intensity varying from 10 to 100 mA and 50 Hz of fixed frequency , with pulse duration of 1 ms . Also , we evaluated 21 patients who were su bmi tted to vaginal cone treatment . The cone therapy was done with two 45 minute sessions per week . The cones ' weight varied from 20 to 100 gr . RESULTS there was no difference between the outcomes of electrostimulation of the pelvic floor and the vaginal cones for the treatment of SUI ( p>0.05 ) . After four months , there was a significant improvement in the I-QoL index of the patients treated both with electrostimulation ( 40.3 versus 82.9 ) or with the cones ( 47.7 versus 84.1 ) . There was a significant decrease in pad weight in both groups , measured before and after the treatment ( 28.5 and 32 g versus 2.0 and 3.0 g for the electrostimulation and cone group , respectively ) . Finally , there was a significant decrease in the number of urinary leakage evaluated by the micturition diary in both groups ( p<0.0001 ) . CONCLUSIONS both electrostimulation and vaginal cones were effective in the treatment of women with SUI OBJECTIVE To evaluate the effects of surface electrical stimulation ( SES ) and to compare them with the effects of the intravaginal electrical stimulation ( IVES ) in women with stress urinary incontinence ( SUI ) . STUDY DESIGN This r and omized controlled study included 48 women aged over 50 years , who complained of SUI evaluated according to two structured questions of King 's Health Question naire ( KHQ ) and who had not previously undergone physical therapy for SUI . The calculation of the sample size estimated a sample of 45 volunteers with a significance level of 5 % and statistical power of 90 % . The women were r and omized to : Surface Electrical Stimulation Group ( SESG ) ( n=15 ) , Intravaginal Electrical Stimulation Group ( IVESG ) ( n=15 ) and Control Group ( CG ) ( n=15 ) . Subjects in the intervention groups were treated with the same parameters of electrical stimulation for 12 sessions . The SESG had four silicone electrodes fixed in the suprapubic and ischial tuberosity regions . The IVES group used an intravaginal electrode . The CG did not receive any treatment during the corresponding time . They were evaluated before and after treatment by a physical therapist who was blind to group allocation . The primary outcomes were urinary leakage , pressure and strength of pelvic floor muscle ( PFM ) contraction . The secondary outcome was quality of life ( QOL ) evaluated by KHQ . Forty-five women completed the study and were included in the analysis . Statistical analysis was performed using the Wilcoxon test for intragroup analysis and Kruskal-Wallis and Mann-Whitney tests for intergroup analysis ( p<0.05 ) . RESULTS There was significant improvement in urinary loss and pressure of contraction in the SESG and IVESG . PFM strength increased only in the IVESG . Intergroup analysis found differences after the treatment in : urinary leakage between the SESG and CG ( p<0.001 ) and the IVESG and CG ( p<0.001 ) . Regarding QOL , there was significant reduction in the incontinence impact , limitations of daily activities , physical limitation , emotion , sleep and disposition and severity domains in the SESG ( all p<0.02 ) and IVESG ( all p<0.04 ) after the treatments . CONCLUSION SES and IVES are important treatments to improve the SUI . Both improved the QOL , urinary leakage , and strength and pressure of PFM contraction PURPOSE To compare the effectiveness of pelvic floor exercises , electrical stimulation , vaginal cones , and no active treatment in women with urodynamic stress urinary incontinence . PATIENTS AND METHODS One hundred eighteen subjects were r and omly selected to recieve pelvic floor exercises ( n=31 ) , ES ( n=30 ) , vaginal cones ( n=27 ) , or no treatment ( untreated control ) ( n=30 ) . Women were evaluated before and after completion of six months of treatment by the pad test , quality of life question naire ( I-QOL ) , urodynamic test , voiding diary , and subjective response . RESULTS In the objective evaluation , we observed a statistically significant reduction in the pad test ( p=0.003 ) , in the number of stress urinary episodes ( p<0.001 ) , and a significant improvement in the quality of life ( p<0.001 ) in subjects who used pelvic floor exercises , electrical stimulation , and vaginal cones compared to the control group . No significant difference was found between groups in the urodynamic parameters . In the subjective evaluation , 58 % , 55 % , and 54 % of women who had used pelvic floor exercises , electrical stimulation , and vaginal cones , respectively , reported being satisfied after treatment . In the control group , only 21 % patients were satisfied with the treatment . CONCLUSION Based on this study , pelvic floor exercises , electrical stimulation , and vaginal cones are equally effective treatments and are far superior to no treatment in women with urodynamic stress urinary incontinence Introduction and hypothesisPelvic floor muscle training ( PFMT ) is a treatment for stress urinary incontinence ( SUI ) that can be done individually or in a group . The aim of this study was to compare these two types of treatment . Methods Sixty women 30 to 75 years old with SUI were r and omly assigned to participate in the two groups . They were evaluated before and after the treatment with the Oxford grading system , pad test , voiding diary , and the King ’s Health Question naire . Results Both groups experienced significant reductions in urinary leakage as measured by the pad test and bladder diary . A negative pad test was observed in about 50 % of patients in both groups . There were statistically significant improvements in both muscle strength and quality of life . When the groups were compared , there were no differences in the results between them . Conclusions Individual treatment and group PFMT appear to be equally effective for improving SUI Abstract Objective : To compare the effect of pelvic floor exercises , electrical stimulation , vaginal cones , and no treatment for  genuine stress incontinence . Design : Stratified , single blind , r and omised controlled trial . Setting : Multicentre . Participants : 107 women with clinical ly and urodynamically proved genuine stress incontinence . Mean ( range ) age was 49.5 ( 24 - 70 ) years , and mean ( range ) duration of symptoms 10.8 ( 1 - 45 ) years . Interventions : Pelvic floor exercise ( n=25 ) comprised 8 - 12 contractions 3 times a day and exercise in groups with skilled physical therapists once a week . The electrical stimulation group ( n=25 ) used vaginal intermittent stimulation with the MS 106 Twin at 50 Hz 30 minutes a day . The vaginal cones group ( n=27 ) used cones for 20 minutes a day . The untreated control group ( n=30 ) was offered the use of a continence guard . Muscle strength was measured by vaginal squeeze pressure once a month . Main outcome measures : Pad test with st and ardised bladder volume , and self report of severity . Results : Improvement in muscle strength was significantly greater ( P=0.03 ) after pelvic floor exercises ( 11.0 cm H2O ( 95 % confidence interval 7.7 to 14.3 ) before v 19.2 cm H2O ( 15.3 to 23.1 ) after ) than either electrical stimulation ( 14.8 cm H2O ( 10.9 to 18.7 ) v 18.6 cm H2O ( 13.3 to 23.9 ) ) or vaginal cones ( 11.8 cm H2O ( 8.5 to 15.1 ) v 15.4 cm H2O ( 11.1 to 19.7 ) ) . Reduction in leakage on pad test was greater in the exercise group ( −30.2 g ; −43.3 to 16.9 ) than in the electrical stimulation group ( −7.4 g ; −20.9 to 6.1 ) and the vaginal cones group ( −14.7 g ; −27.6 to −1.8 ) . On completion of the trial one participant in the control group , 14 in the pelvic floor exercise group , three in the electrical stimulation group , and two in the vaginal cones group no longer considered themselves as having a problem . Conclusion : Training of the pelvic floor muscles is superior to electrical stimulation and vaginal cones in the treatment of genuine stress incontinence Introduction and hypothesisTo compare the effects of pelvic floor muscle training ( PFMT ) , with or without biofeedback ( BF ) , for stress urinary incontinence ( SUI ) , focusing on condition-specific quality of life ( QOL ) outcomes . Methods Women with SUI were r and omized to PFMT with BF ( BF group , n = 23 ) or without BF ( PFMT group , n = 23 ) for 12 weeks . As primary outcome measures , subjective symptoms and QOL were assessed by the King ’s Health Question naire ( KHQ ) and International Consultation on Incontinence Question naire-Short Form ( ICIQ-SF ) . A voiding diary , 1-h pad test , and measurement of PFM strength were secondary outcome measures . Changes in the primary and secondary outcomes were assessed before and after 12 weeks ’ exercise training . Results Of the 9 domains of the KHQ , the scores of 5 significantly decreased in the PFMT group , and the scores of 7 significantly decreased in the BF group . All ICIQ-SF items and the total score significantly decreased in both groups after therapy . The number of incontinence episodes significantly decreased in the PFMT group , and tended to decrease in the BF group , but this was not significant ( P = 0.054 ) . The leakage volume in the 1-h pad test tended to decrease in both groups , but was not significant . Maximum vaginal squeeze pressure significantly increased in both groups . There were no significant inter-group differences in the changes in any of the parameters assessed . Conclusions The results indicate that PFMT is effective for treating SUI . There is no apparent add-on effect of BF training in short-term follow-up OBJECTIVE : The aim of this study was to compare the effectiveness of multimodal supervised physiotherapy programs with the absence of treatment among women with persistent postnatal stress urinary incontinence . METHODS : This was a single-blind r and omized controlled trial . Sixty-four women with stress urinary incontinence were r and omly assigned to 8 weeks of either multimodal pelvic floor rehabilitation ( n = 21 ) , multimodal pelvic floor rehabilitation with abdominal muscle training ( n = 23 ) , or control non – pelvic floor rehabilitation ( n = 20 ) . The primary outcome measure consisted of a modified 20-minute pad test . The secondary outcome measures included a Visual Analog Scale describing the perceived burden of incontinence , the Urogenital Distress Inventory , the Incontinence Impact Question naire , and pelvic floor muscle function measurements . RESULTS : Two patients dropped out , leaving 62 for analysis . At follow-up , more than 70 % of the women in the treatment groups ( 14/20 in the pelvic floor and 17/23 in the pelvic floor plus abdominal group ) were continent on pad testing compared with 0 % of women in the control 
    Output:
    
Combining biofeedback with PFMT had an uncertain effect on QoL ( MD = -4.4 points ; CI 95 % = -16.69 to 7.89 points ) , but better results on the pad test , although with elevated heterogeneity ( MD = 0.9 g ; 95%CI = 0.71 to 1,10 g ) ; group PFMT was not less efficacious than individual treatment , and home PFMT was not consistently worse than supervised PFMT .
Both intravaginal and superficial electrical stimulation ( IES and SES ) were better than no treatment for QoL and pad test .
The association of IES with PFMT may improve the efficacy of the latter for QoL and pad test , but the results of individual studies were not consistent .
Thus , there is evidence of the use of PFMT on the treatment of SUI , with and without biofeedback