Conservative management for postprostatectomy urinary incontinence

Campbell, Susan; Glazener, Cathryn; Hunter, Kathleen F.; Cody, June D; Moore, Katherine

doi:10.1002/14651858.cd001843.pub4

Cited by 81 publications

(98 citation statements)

References 85 publications

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“…The working methodology varied among the four studies analyzed [4,24,25,26], but they all involved a daily exercise routine. Despite the variability in the number and frequency of clinic visits performed in the RCTs, there is little evidence that more visits result in a higher continence rate [13]. …”

Section: Discussionmentioning

confidence: 99%

“…This includes pelvic floor muscle training (PFMT), with or without biofeedback, to help increase urethral closure pressure during exertion episodes. However, the value of the various approaches to conservative management of incontinence after radical prostatectomy remains uncertain [13]. Thus, the aim of this meta-analysis was to evaluate the evidence on the effect of PFMT on UI after radical prostatectomy.…”

Section: Introductionmentioning

confidence: 99%

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Improvement of Continence Rate with Pelvic Floor Muscle Training Post-Prostatectomy: A Meta-Analysis of Randomized Controlled Trials

et al. 2014

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Objective: The aim of this meta-analysis was to evaluate the evidence of the effect of pelvic floor muscle training on urinary incontinence after radical prostatectomy. Methods: A bibliographic search was conducted in four databases. Studies were grouped according to the intervention program (muscle training versus control and individual home-based versus physiotherapist-guided muscle training). Results: Eight studies were selected for meta-analysis after satisfying the selection criteria. The data show that pelvic floor muscle training improves continence rate in the short (RR = 2.16; p < 0.001), medium (RR = 1.45; p = 0.001) and long term (RR = 1.23; p = 0.019) after surgery. The number of randomized controlled trials and the heterogeneity in the study population and type of pelvic floor muscle training were the main limitations. Conclusion: Programs including at least three sets of 10 repetitions of muscle training daily appear to improve continence rate after radical prostatectomy. Our meta-analysis shows that muscle training programs for urinary incontinence provide similar results to those of physiotherapist-guided programs, therefore being more cost- effective.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improvement of Continence Rate with Pelvic Floor Muscle Training Post-Prostatectomy: A Meta-Analysis of Randomized Controlled Trials

et al. 2014

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“…A Cochrane review, published in 2012, which assessed the effects of ‘conservative’ management for UI after prostatectomy, concluded that there remains no clear support that conservative management of any type for postprostatectomy UI is either helpful or harmful, whether delivered as treatment to men who are incontinent or as prevention to all men undergoing RP 72. It must be noted that the Cochrane review did not stratify studies in early vs. late initiation PFMT or preoperative vs. postoperative PFMT or physiotherapist‐guided (with/without biofeedback) vs. standard care PFMT.…”

Section: Discussionmentioning

confidence: 99%

Integrative review on the non‐invasive management of lower urinary tract symptoms in men following treatments for pelvic malignancies

et al. 2015

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SummaryAimTo develop a non‐invasive management strategy for men with lower urinary tract symptoms (LUTS) after treatment for pelvic cancer, that is suitable for use in a primary healthcare context.MethodsPubMed literature searches of LUTS management in this patient group were carried out, together with obtaining a consensus of management strategies from a panel of authors for the management of LUTS from across the UK.ResultsData from 41 articles were investigated and collated. Clinical experience was sought from authors where there was no clinical evidence. The findings discussed in this paper confirm that LUTS after the cancer treatment can significantly impair men's quality of life. While many men recover from LUTS spontaneously over time, a significant proportion require long‐term management. Despite the prevalence of LUTS, there is a lack of consensus on best management. This article offers a comprehensive treatment algorithm to manage patients with LUTS following pelvic cancer treatment.ConclusionBased on published research literature and clinical experience, recommendations are proposed for the standardisation of management strategies employed for men with LUTS after the pelvic cancer treatment. In addition to implementing the algorithm, understanding the rationale for the type and timing of LUTS management strategies is crucial for clinicians and patients.

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“…Conservative treatment of post-prostatectomy incontinence has typically included pelvic floor muscle exercise programmes that encourage activation of the anal sphincter [21][22][23]. Given the evidence of lack of efficacy of current methods [24], new approaches should be considered. The use of US to as a feedback to aid retraining of activation of pelvic floor muscles relevant to maintenance of urinary continence (e.g.…”

Section: Clinical Significancementioning

confidence: 99%

Validity of estimation of pelvic floor muscle activity from transperineal ultrasound imaging in men

Stafford¹,

Hodges²,

Lutton³

et al. 2015

UQ eSpace

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PurposeTo investigate the relationship between displacement of pelvic floor landmarks observed with transperineal ultrasound imaging and electromyography of the muscles hypothesised to cause the displacements. Materials and MethodsThree healthy men participated in this study, which included ultrasound imaging of the midurethra, urethra-vesical junction, ano-rectal junction and bulb of the penis. Fine-wire electromyography electrodes were inserted into the puborectalis and bulbocavernosus muscles and a transurethral catheter electrode recorded striated urethral sphincter electromyography. A nasogastric sensor recorded intra-abdominal pressure. Tasks included submaximal and maximal voluntary contractions, and Valsalva. The relationship between each of the parameters measured from ultrasound images and electromyography or intra-abdominal pressure amplitudes was described with nonlinear regression. ResultsStrong, non-linear relationships were calculated for each predicted landmark/muscle pair for submaximal contractions (R 2 -0.87-0.95). The relationships between mid-urethral displacement and striated urethral sphincter electromyography, and bulb of the penis displacement and bulbocavernosus electromyography were strong during maximal contractions (R 2 -0.74-0.88). Increased intra-abdominal pressure prevented shortening of puborectalis, which resulted in weak relationships between electromyography and anorectal and urethravesical junction displacement during all tasks.

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Conservative management for postprostatectomy urinary incontinence

Cited by 81 publications

References 85 publications

Improvement of Continence Rate with Pelvic Floor Muscle Training Post-Prostatectomy: A Meta-Analysis of Randomized Controlled Trials

Improvement of Continence Rate with Pelvic Floor Muscle Training Post-Prostatectomy: A Meta-Analysis of Randomized Controlled Trials

Integrative review on the non‐invasive management of lower urinary tract symptoms in men following treatments for pelvic malignancies

Validity of estimation of pelvic floor muscle activity from transperineal ultrasound imaging in men

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