A growing number of researches suggested that preoperative pelvic floor muscle exercise (PFME) was beneficial for urinary incontinence (UI) after a prostatectomy. However, these studies are debatable and inconclusive. Hence, this article aimed to determine whether PFME improves UI after a radical prostatectomy (RP).
PubMed, Embase, Medline and Cochrane Library were searched for articles published from 2014 to October 2019 based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). This study was evaluated based on the Oxford Evidence-Based Medicine Center. A total of 1,269 subjects (experimental group: 628, control group: 641) in 18 studies met the inclusion criteria. In 18 studies, enough quantitative data on postoperative incontinence were available for meta-analysis. UI was analyzed at 1, 3, 6 and 12 months and all comparative studies were pooled using fixed and random effects models. Contour-enhanced funnel plots were used to assess publication bias.
Pooled data revealed a total of 1,269 UI patients that underwent preoperative PFME, including PFME (N=628, 49.48%) and control group (N=641, 50.51%). There was no significant difference in the postoperative incontinence rates at 1 month (RR: 0.85, 95% CI: 0.66-1.09, P=0.031, I2=62.4%), 6 weeks (RR: 0.95, 95% CI: 0.85-1.05, P=0.618, I2=0.0%), 3 months (RR: 0.92, 95% CI: 0.63-1.34, P=0.000, I2=83.2%), 6 months (RR: 0.86, 95% CI: 0.69-1.08, P=0.364, I2=8.4%) or 12 months (RR: 0.83, 95% CI: 0.47-1.47, P=0.596, I2=0.0%) after operation.
Contrary to previous work, the results presented here indicated that preoperative PFME protocols did not reduce the rate of UI. Further high-quality randomized controlled trials are necessary in the future to verify these findings.
Translational andrology and urology. 2020 Oct [Epub]
Hong Cheng, Yi Wang, Feng Qi, Shuhui Si, Xiao Li, Ming Chen
Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China., Department of Urology, Affiliated Hospital of Nantong University, Nantong, China., Department of Urology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China., Department of Pharmacy, the General Hospital of the People's Liberation Army Eastern Theater Command, Nanjing, China.