Preoperative Pelvic Muscle Training for Continence Recovery After Prostatectomy: Yet Another Meta-Analysis?

Urinary incontinence is a common complication after radical prostatectomy. Several meta-analyses have evaluated the effectiveness of pelvic floor muscle training (PFMT) for continence recovery, but their findings are inconsistent, and not all include all relevant studies. This meta-analysis aims to address these gaps.

The study aims to summarize evidence on the effectiveness of preoperative PFMT, with or without biofeedback, on continence recovery post-prostatectomy.

A systematic review and meta-analysis were conducted following PRISMA guidelines. The PICO framework was used: Patients undergoing radical prostatectomy, Intervention: preoperative PFMT, Comparison: any postoperative intervention or monitoring, Outcome: continence recovery. Studies were sourced from PubMed, CINAHL, Scopus, Web of Science, and PEdro. Quality was assessed using the PEdro scale, and statistical analysis was performed using a random effect model.

Six studies were included. Preoperative PFMT did not significantly improve continence recovery 1 month post-surgery (odds-ratio 2.01, 95% CI [0.94-4.31], p = 0.37). However, a significant improvement was observed 3 months post-surgery (odds-ratio 1.52, 95% CI [1.05-2.20], p = 0.03). No significant differences were found at 6 months (odds-ratio 1.28, 95% CI [0.85-1.94], p = 0.95) and twelve months (odds-ratio 0.73, 95% CI [0.43-1.23], p = 0.32).

Preoperative PFMT may improve continence recovery 3 months post-surgery but not at one, six, or twelve months. The study highlights the need for standardized assessment criteria and further research on robotic-assisted prostatectomy. The innovative aspect of this study lies in its conservative inclusion criteria and focus on preoperative PFMT's potential benefits.

Not applicable. This study did not require clinical trial registration because it is a systematic review and meta-analysis of previously published studies.