Conservative management for post prostatectomy urinary incontinence

Abstract

Background: Urinary incontinence after prostatectomy is a common problem. Conservative management of this condition includes pelvic floor muscle training, biofeedback, electrical stimulation using a rectal electrode, transcutaneous electrical nerve stimulation, or a combination of methods.

Objectives: To assess the effects of conservative management for urinary incontinence after transurethral, suprapubic, radical retropubic or perineal prostatectomy.

Search strategy: The Cochrane Incontinence Group's trials register, Medline, Cinahl, Embase, PsycLit and ERIC all up to January 1999, and reference lists of relevant articles. We contacted investigators to locate studies and we handsearched the following conference proceedings: American Urological Association (1989-1999); Society of Urologic Nurses and Associates (1991-1998); Wound Ostomy and Continence Nurses (1996-1999); and International Continence Society (1980-1998). Date of most recent searches: January 1999.

Selection criteria: Randomised or quasi-randomised trials which evaluated conservative management aimed at improving urinary continence after prostatectomy.

Data collection and analysis: Two reviewers independently assessed the methodological quality of studies and abstracted data from included trials onto a standard form.

Main results: Only five randomised trials were identified which included 365 men, each evaluating different treatments, and all studying men after radical prostatectomy. The trials were of moderate quality and data were not available for many of the pre-stated outcomes. Confidence intervals for both dichotomous and continuous data were wide; it was not possible to reliably identify or rule out a useful effect. Men's symptoms tended to improve over time, irrespective of management.

Reviewer's conclusions: The value of the various approaches to conservative management of post prostatectomy incontinence remains uncertain. Further well designed trials are needed.