1007 Intensive preoperatory Pelvic Floor Muscle Training reduce duration and severity of stress urinary incontinence after radical prostatectomy: A randomized controlled trial

Preoperative pelvic floor muscle exercise for continence after radical prostatectomy: a systematic review and meta-analysis

Objective

We performed a systematic review and meta-analysis to evaluate the effect of preoperative pelvic floor muscle exercise on urinary incontinence after radical prostatectomy.

Methods

We searched the literature for randomized controlled trials evaluating the diagnostic analysis of preoperative pelvic floor muscle exercise (PFME) and postprostatectomy incontinence in the MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, China Biomedical Literature Database, China Journal Full-text Database, Wanfang Database and Weipu Database. The retrieval time limit is from the establishment of the database to January 2023. We used a risk ratio with accompanying 95% confidence interval (CI) to express estimates. Reviewer Manager (RevMan) 5.1.0 was used to complete all statistical analyses.

Results

Twelve studies were included based on the selection criteria. The total number of patients included in the final analysis was 1,365. At 1th month, there was no difference in continence rates between the groups [odds ratio (OR): 0.47; 95% confidence interval (CI), 0.22-1.02, p = 0.06]. At 3th month, there was statistically significant difference in PFME group before operation (OR: 0.61; 95% CI, 0.37-0.98, p = 0.04). At 6th and 12th months, there was no difference between groups (OR: 0.57; 95% CI, 0.28-1.17, p = 0.13), (OR: 0.56; 95% CI, 0.27-1.15, p = 0.12).

Conclusion

Preoperative pelvic floor muscle exercise can improve postoperative urinary incontinence at 3rd months after radical prostatectomy, but it cannot improve urinary incontinence at 6th months or longer after surgery, which indicates that preoperative PFME can improve early continence rate, but cannot improve long-term urinary incontinence continence rate.

Preoperative Pelvic Floor Muscle Exercise and Postprostatectomy Incontinence: A Systematic Review and Meta-analysis

CONTEXT

Preoperative pelvic floor muscle exercise (PFME) is often prescribed to reduce the severity of postprostatectomy incontinence.

OBJECTIVE

Systematic review and meta-analysis of evidence regarding the effect of preoperative PFME on postoperative urinary incontinence following radical prostatectomy.

EVIDENCE ACQUISITION

A systematic search was performed of the Cochrane Library, Medline, Embase, and all potential articles from references in relevant articles on 4 October 2014. We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Identified reports were critically appraised for quality and relevance. Only studies of preoperative PFME compared with no preoperative PFME were included.

EVIDENCE SYNTHESIS

Eleven studies were included based on the selection criteria. The total number of patients included in the final analysis was 739. In seven studies, sufficient quantitative data on postoperative incontinence were available for meta-analysis. At 1 mo, there was no difference in continence rates between the groups (odds ratio [OR]: 0.68; 95% confidence interval [CI], 0.45-1.03). At 3 mo, there was 36% improvement in the preoperative PFME group (OR: 0.64; 95% CI, 0.47-0.88). At 6 mo, there was no difference between groups (OR: 0.60; 95% CI, 0.32-1.15). When examining quality of life measures, four of seven studies demonstrated significant improvement in the preoperative PFME group at 3 mo, and two of these studies demonstrated significant differences at 6 mo.

CONCLUSIONS

Preoperative PFME improves postoperative urinary incontinence after radical prostatectomy at 3 mo but not at 6 mo, suggesting it improves early continence but not long-term continence rates.

PATIENT SUMMARY

We reviewed all evidence for preoperative pelvic floor muscle exercise (PFME) in treating urinary incontinence following radical prostatectomy. We found evidence to suggest that preoperative PFME improves early continence rates but not long-term continence rates.