A systematic review of PFE pre-prostatectomy.

Area of Science:

• Urology
• Rehabilitation Medicine
• Men's Health

Background:

• Male stress urinary incontinence is a common complication following robotic radical prostatectomy, significantly impacting patients' quality of life.
• Weak pelvic floor muscles are a primary cause of post-prostatectomy incontinence and erectile dysfunction.

Purpose of the Study:

• To systematically review the literature on the impact of preoperative pelvic floor exercises (PFE) on continence outcomes in patients undergoing prostatectomy.
• To assess the benefits of PFE for improving early continence and quality of life after radical prostatectomy (RP).

Main Methods:

• A systematic literature review was conducted using databases including CINAHL, MEDLINE, Cochrane, EMBASE, and Web of Science from 2000 to September 2017.
• Search terms included "Pelvic floor exercises," "incontinence," and "prostatectomy." MeSH terms and keywords were also utilized.
• Consultation with two UK-based experts in prostate cancer and robotic surgery identified additional relevant studies.

Main Results:

• Studies indicate that preoperative PFE may improve early continence rates after RP, with continence defined as using one pad or less per day.
• The "incontinence impact" was found to be more favorable in groups performing PFE at 3 and 6 months post-surgery.
• Starting PFE 30 days before RP and continuing postoperatively demonstrated benefits for early continence recovery and quality of life.

Conclusions:

• Preoperative pelvic floor muscle exercise (PFE) is associated with improved early continence and quality of life outcomes after radical prostatectomy.
• Strengthening pelvic floor muscles through PFE is recommended for all men to maintain normal function and manage post-prostatectomy incontinence.
• PFE can significantly improve post-prostatectomy urinary continence, post-micturition dribble, and erectile function.