Analysis of conventional versus advanced pelvic floor muscle training in the management of urinary incontinence after radical prostatectomy: a systematic review and meta-analysis of randomized controlled trials

Feng, Dechao; Liu, Shengzhuo; Li, Dengxiong; Zhang, Facai; Wei, Wuran

doi:10.21037/tau-20-615

Cited by 25 publications

(23 citation statements)

References 43 publications

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“…On a global scale, the agestandardized incidence rate of PCA increased from 30.5 cases per 100,000 population in 1990 to 37.9 cases per 100,000 population in 2017, which is positively related to the sociodemographic index in most regions (2). The PCA incidence has been increasing in most Asian countries, ranking first in Chinese men regarding its incidence and mortality among all urologic tumors (1,3). This increase might be attributed to not only increased PSA screening but also the conversion of a westernized lifestyle (4).…”

Section: Introductionmentioning

confidence: 99%

Identification of a Novel Nomogram to Predict Progression Based on the Circadian Clock and Insights Into the Tumor Immune Microenvironment in Prostate Cancer

et al. 2022

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BackgroundCurrently, the impact of the circadian rhythm on the tumorigenesis and progression of prostate cancer (PCA) has yet to be understood. In this study, we first established a novel nomogram to predict PCA progression based on circadian clock (CIC)-related genes and provided insights into the tumor immune microenvironment.MethodsThe TCGA and Genecards databases were used to identify potential candidate genes. Lasso and Cox regression analyses were applied to develop a CIC-related gene signature. The tumor immune microenvironment was evaluated through appropriate statistical methods and the GSCALite database.ResultsTen genes were identified to construct a gene signature to predict progression probability for patients with PCA. Patients with high-risk scores were more prone to progress than those with low-risk scores (hazard ratio (HR): 4.11, 95% CI: 2.66-6.37; risk score cut-off: 1.194). CLOCK, PER (1, 2, 3), CRY2, NPAS2, RORA, and ARNTL showed a higher correlation with anti-oncogenes, while CSNK1D and CSNK1E presented a greater relationship with oncogenes. Overall, patients with higher risk scores showed lower mRNA expression of PER1, PER2, and CRY2 and higher expression of CSNK1E. In general, tumor samples presented higher infiltration levels of macrophages, T cells and myeloid dendritic cells than normal samples. In addition, tumor samples had higher immune scores, lower stroma scores and lower microenvironment scores than normal samples. Notably, patients with higher risk scores were associated with significantly lower levels of neutrophils, NK cells, T helper type 1, and mast cells. There was a positive correlation between the risk score and the tumor mutation burden (TMB) score, and patients with higher TMB scores were more prone to progress than those with lower TMB scores. Likewise, we observed similar results regarding the correlation between the microsatellite instability (MSI) score and the risk score and the impact of the MSI score on the progression-free interval. We observed that anti-oncogenes presented a significantly positive correlation with PD-L1, PD-L2, TIGIT and SIGLEC15, especially PD-L2.ConclusionWe identified ten prognosis-related genes as a promising tool for risk stratification in PCA patients from the fresh perspective of CIC.

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Section: Introductionmentioning

confidence: 99%

Identification of a Novel Nomogram to Predict Progression Based on the Circadian Clock and Insights Into the Tumor Immune Microenvironment in Prostate Cancer

et al. 2022

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“…Unfortunately, a previous review showed the increased trend of incidence of metastatic PCA from 2007 to 2013, and the greatest increment was seen in men aged 55-69 years (92% increase from 2004 to 2013) [36]. Management of PCA currently includes surgery, radiotherapy and hormone therapy [4]. Immunotherapy for PCA patients has emerged in recent years, which has been demonstrated to be effective for other tumours, such as metastatic melanoma, renal and lung cancer [37].…”

Section: Discussionmentioning

confidence: 99%

“…The treatment modalities of PCA mainly consist of observation (active surveillance or watchful waiting), local curative treatment (RP or radical radiotherapy), and hormone therapy, depending on age, tumour stage, presence of metastasis and patient performance and reference [4]. Observation is the most effective choice for low-risk PCA patients aged 65-75 years [6]; however, about 30% of patients with intermediate or high-risk localized and locally advanced cancer experience recurrence and subsequently succumb to the disease despite surgery and radiation [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Prostate specific antigen (PSA) testing has been a routine screening method of preclinical PCA for many years; however, a recent review indicates that PSA testing mainly identify indolently low‐grade cases, which are unlikely to escalate during their lifetime, and too few low‐grade patients can benefit from radical prostatectomy (RP) to justify interventions in all [2]. Moreover, the previous studies showed that the 10‐year rate of cancer specific survival could be up to more than 90% for moderately and highly differentiated PCA patients [3,4]. Thus, the US Preventive Service Task Force recommends informed decision‐making for PSA testing in men aged 55 to 69 years to avoiding overdiagnosis and overtreatment‐related adverse effects [5].…”

Section: Introductionmentioning

confidence: 99%

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Developing an immune‐related gene prognostic index associated with progression and providing new insights into the tumor immune microenvironment of prostate cancer

Feng

Zhang

et al. 2022

Immunology

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We developed an immune‐related gene prognostic index (IGPI) associated with progression and provided new insights into the tumour immune microenvironment (TIME) for prostate cancer (PCA) patients undergoing radical prostatectomy. All analyses were conducted with R software (version 3.6.3) and its suitable packages. Meta‐analysis was performed with STATA 16.0. TUBB3, WDR62 and PPARGC1A were finally identified to establish the IGPI score. The IGPI score increased with the augment of the Gleason score and T stage, as well as biochemical recurrence (BCR) and prostate specific antigen (PSA). Patients with a higher IGPI score were at a higher risk of progress (HR: 2·88; 95%CI: 95%CI: 1·80–4·61). Gene set enrichment analysis indicated that patients in high‐risk group were positively associated with mismatch repair, cell cycle, DNA replication, base excision repair, nucleotide excision repair, homologous recombination and pyrimidine metabolism. We observed that patients in the high‐risk group had significantly higher tumour mutation burden score and microsatellite instability score than those in the low‐risk group. For analysis of immune checkpoint, ADORA2A, CD80, TNFRSF4, TNFRSF18 and TNFRSF25 were differentially expressed between no progress and progress groups and were significantly associated with progress free survival. We observed positive correlations between the IGPI score and lymphoid immune cells, macrophages M2 and immune score, while negative association between the IGPI score and dendritic cells, fibroblasts, stromal score and microenvironment score. In conclusion, the IGPI score constructed in this study might serve as an independent risk factor associated with PCA progression. ADORA2A, CD80, TNFRSF4, TNFRSF18 and TNFRSF25 might be the potential targets in the treatment of PCA.

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“…Kegel's exercises, first proposed in 1948 for post-partum incontinence 11 have been proving their efficacy in many studies on male patients. [12][13][14] They consist in voluntary contractions of the pelvic muscles, aimed to strengthen them (especially the pubococcygeus) and improve their endurance. The goal is to use the muscular group called 'levator ani' to help the sphincter constrict the urethra.…”

Section: Introductionmentioning

confidence: 99%

Long‐term effect of extracorporeal magnetic innervation for post‐prostatectomy urinary incontinence: 1‐year follow‐up

Terzoni

Ferrara

Mora

et al. 2021

Int J of Uro Nursing

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Urinary incontinence after radical prostatectomy is a common and bothersome problem. Pelvic floor muscle training (PFMT) is supported by strong recommendations in the European guidelines as the first-choice rehabilitation method. Extracorporeal magnetic innervation (ExMI) has been studied in a previous pilot investigation by our team and seemed useful for shortening the duration of the rehabilitation programme, although patients still need to perform maintenance PFMT regardless of the method chosen for rehabilitation. Very few data exist in literature about its long-term effects on men; the need for additional evidence therefore remains. To investigate the longterm effects of ExMI associated with maintenance PFMT, compared to PFMT alone, in maintaining continence after the end of a rehabilitation programme. Follow-up study on 83 rehabilitated patients (67 PFMT, 16 ExMI). All patients were instructed by a nurse specialist to perform the same maintenance PFMT exercises, based on the literature. Pad-test was performed by all patients after 3, 6 and 12 months from the end of the rehabilitation programme. As in previously published studies, rehabilitation was defined as leakages <10 g/day based on a literature definition. A mixed effects linear model was used to assess differences between residual leakages over time.Both PFMT and ExMI gave clinically satisfactory results during the whole follow-up period, without statistically significant differences in the leakages. However, the correlation coefficients suggest that the results are more stable in the PFMT group over time, with less variations in the residual leakages. ExMI can be used during rehabilitation to speed up recovery, but PFMT are still needed for maintenance and provide better results in the long run, even though ExMI also provides satisfactory continence outcomes at follow-up. Studies on larger samples are needed to confirm these findings.

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Analysis of conventional versus advanced pelvic floor muscle training in the management of urinary incontinence after radical prostatectomy: a systematic review and meta-analysis of randomized controlled trials

Cited by 25 publications

References 43 publications

Identification of a Novel Nomogram to Predict Progression Based on the Circadian Clock and Insights Into the Tumor Immune Microenvironment in Prostate Cancer

Identification of a Novel Nomogram to Predict Progression Based on the Circadian Clock and Insights Into the Tumor Immune Microenvironment in Prostate Cancer

Developing an immune‐related gene prognostic index associated with progression and providing new insights into the tumor immune microenvironment of prostate cancer

Long‐term effect of extracorporeal magnetic innervation for post‐prostatectomy urinary incontinence: 1‐year follow‐up

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