Effect of pelvic floor muscle training on urinary incontinence after radical prostatectomy: An umbrella review of meta-analysis and systematic review

Abstract

Objective To analyse the specific exercise effects of pelvic floor muscle training (PFMT) with or without biofeedback or electrical stimulation on urinary incontinence rehabilitation after radical prostatectomy. Data sources We searched PubMed, Embase, Cochrane Database of Systematic Reviews, Web of Science and Scopus databases for systematic reviews and meta-analyses on PFMT for urinary incontinence after radical prostatectomy from inception to 3 October 2022. Review methods Two authors independently extracted key data from the included studies. The methodological quality of the included studies was assessed using the A Measure Tool to Assess Systematic Reviews-2 checklist. Grading of Recommendations Assessment Development and Evaluation was used to evaluate the quality of the outcomes. Results A total of 18 studies with 29,925 patients were included, all of which were of critically low methodological quality. Biofeedback therapy seemed to show additional benefits compared to PFMT alone; however, the adjunctive role of electrical stimulation remained more controversial due to the lack of strong evidence. Preoperative PFMT sometimes, but not always, showed the potential to improve urinary incontinence. PFMT with the guidance of a therapist could bring some benefits to the patient and was more acceptable to the patient, but consumed some medical resources. Conclusions PFMT has a good effect on improving post-radical prostatectomy incontinence in men, and biofeedback can have an additional beneficial effect on patients, especially in the short-term and medium-term. However, there is insufficient evidence to suggest that electrical stimulation is beneficial for patients with urinary incontinence.

Patient’s Desire and Real Availability Concerning Supportive Measures Accompanying Radical Prostatectomy: Differences between Certified Prostate Cancer Centers and Non-Certified Centers Based on Patient-Reported Outcomes within the Cross-Sectional Study Improve

“…In addition to the intended impact of radical prostatectomy on the oncological outcomes, this procedure clearly has a functional component, resulting in stress urinary incontinence (in varying degrees) and erectile dysfunction in some of the surgically treated patients, leading to a significant impact on the quality of life [22][23][24]. For this reason, perioperative pelvic floor muscle training should be offered to patients by urologic centers, and therapeutic counselling should be offered to patients with postoperative erectile dysfunction problems in an outpatient setting [25][26][27]. Additionally, multidisciplinary patient counselling, given by a surgeon and a radiotherapist together prior to the decision on the best treatment option, may further help to reduce patients' decision regret in some cases.…”

Unmet Supportive Care Needs of Prostate Cancer survivors in China: A Cross-Sectional Study

“…Fortunately, advancements in early detection, surgery, and adjuvant therapy have enabled an increasing number of patients to transition into the convalesence phase and become cancer survivors [3]. However, due to the disease itself and treatment side effects, survivors often experience complications such as urinary incontinence [4,5] sexual dysfunction [6,7], among others. Additionally, concerns over substantial financial burden [8,9] persist.…”