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Conservative management for postprostatectomy urinary incontinence
K F Hunter1, C M A Glazener, K N Moore
1University of Alberta Faculty of Nursing, Edmonton, Alberta, Canada. Kathleen.Hunter@ualberta.ca
The Cochrane Database of Systematic Reviews
|April 20, 2007
Summary
Conservative management for post-prostatectomy urinary incontinence has uncertain benefits. Pelvic floor muscle training (PFMT) showed mixed results, and external penile clamps may help long-term but have safety concerns.
Area of Science:
- Urology
- Evidence-Based Medicine
Background:
- Urinary incontinence is a common complication following radical prostatectomy (RP) and transurethral resection of the prostate (TURP).
- Conservative management options include pelvic floor muscle training (PFMT), electrical stimulation, compression devices, and lifestyle changes.
Purpose of the Study:
- To evaluate the effectiveness of conservative management strategies for urinary incontinence after prostatectomy.
Main Methods:
- Systematic review of randomized and quasi-randomized controlled trials.
- Searched multiple databases (MEDLINE, EMBASE, CINAHL, etc.) up to January 2006.
- Assessed methodological quality and abstracted data from 17 included trials.
Main Results:
- Seventeen trials (15 RP, 1 TURP, 1 either) showed considerable variation in interventions and outcomes.
- Postoperative PFMT for RP incontinence yielded conflicting results; preventative PFMT also showed heterogeneity.
- Data for other conservative interventions and TURP incontinence were inconclusive; symptoms often improved spontaneously over time.
Conclusions:
- The efficacy of conservative management for postprostatectomy incontinence remains uncertain.
- External penile clamps may offer long-term incontinence management but pose safety issues.
- Further high-quality research is needed to clarify treatment effects.
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