Behavioral treatments for post-prostatectomy incontinence

Despite improvements in surgical approaches to radical prostatectomy, many patients experience moderate to severe urinary incontinence during the first few postoperative weeks. For some patients, leakage continues for several months or years. Urinary incontinence has a significant impact on quality of life in these typically active patients. Surgical interventions are not recommended until after a 6 to 12 month trial of behavioral interventions. Behavioral interventions include supportive care, diet and medication management, pelvic floor rehabilitation, inhibition techniques, and patient education and support. This integrative review of the literature summarizes current knowledge of behavioral interventions for post-prostatectomy urinary incontinence for the primary care and home care clinician. Aspects of care specific to masculine culture are explored. Recommendations for further research include determination of optimal timing and protocols for pelvic floor rehabilitation, best practices for patient and family education, and development of a standard definition of urinary incontinence so the efficacy of treatments can be compared.