Efficacy of bladder training in the overactive bladder symptoms improvement: systematic review protocol

Abstract Background The International Continence Society recommends that first-line treatment of overactive bladder syndrome symptoms and urgency urinary incontinence is performed by conservative interventions. Bladder training is considered one of the types of behavioral intervention, which is characterized by health education associated with scheduled voiding regimen with gradually adjusted voiding intervals. The aim of this study will be to investigate and update whether bladder training can promote improvement of symptoms of individuals with overactive bladder with or without urgency urinary incontinence. Methods A bibliographic search will be conducted in eight databases, no data or language restrictions: PubMed, PEDro, SciELO, LILACS, Cochrane Library, Web of Science, EMBASE, CINAHL, by handing searching. A combination of search terms including ‘bladder training’, 'overactive bladder', ‘urinary incontinence’ and 'urinary urgency incontinence' with common Boolean operators will be used. Specific search terms will be combined with either MeSH and search descriptors terms and appropriate permutations for each database. Search findings will be imported into the Reference Management Software (Mendeley 2.67.0) then uploaded where two reviewers will screen the titles, abstracts and retrieved full text. In case of conflicts and moderate consensus discussions, a third reviewer will be available. The Mixed Methods Appraisal Tool (MMAT) will be used to appraise the quality of mixed studies (quantitative and qualitative) by limiting them to criteria. The primary outcome will be the improvement of OAB symptoms and the secondary outcomes will be the quality of life, functional assessment and adverse events, which can be assessed by questionnaires and measurement instruments. Meta-analysis, if plausible, will be performed by the software Review Manager 5.4. Cochrane RoB 2 assesses the risk of bias for randomized trials and quality of evidence will be assessed by GRADE. Discussion This study is a review of randomized controlled studies to analyze the efficacy of bladder training improving overactive bladder syndrome symptoms. The study design of randomized controlled trials for a higher level of scientific evidence was chosen. The aim is to obtain results that allow further studies and evidence that this intervention generates beneficial effects in the sample studied. Systematic review registration: PROSPERO CRD42022301522.