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. 2020 Oct;9(5):2031-2045.
doi: 10.21037/tau-20-615.

Analysis of conventional versus advanced pelvic floor muscle training in the management of urinary incontinence after radical prostatectomy: a systematic review and meta-analysis of randomized controlled trials

Dechao Feng  1 , Shengzhuo Liu  1 , Dengxiong Li  1 , Ping Han  1 , Wuran Wei  1
Affiliations

Analysis of conventional versus advanced pelvic floor muscle training in the management of urinary incontinence after radical prostatectomy: a systematic review and meta-analysis of randomized controlled trials

Dechao Feng et al. Transl Androl Urol. 2020 Oct.

Abstract

Background: The underutilization of additional supportive muscles is one of the potential reasons for suboptimal efficacy of conventional pelvic floor muscle training (CPFMT). The present study concentrates on any advantage of advanced pelvic floor muscle training (APFMT) in patients with urinary incontinence (UI) after radical prostatectomy (RP).

Methods: Literature search was conducted on PubMed, Embase, Cochrane Library and Web of Science from database inception to February 2020. The data analysis was performed by the Cochrane Collaboration's software RevMan 5.3.

Results: Both APFMT and CPFMT groups indicates superiority over baseline in terms of pad number, the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score, pad weight at short-term follow-up, and PFME and PFMS at intermediate-term follow-up. No adverse events were reported in all included studies. Patients receiving APFMT had a similar attrition rate to those receiving CPFMT (18/236 vs. 22/282, P=0.61). Compared to CPFMT group, APFMT group provided intermediate-term advantages in terms of pad number (MD: -0.75, 95% CI: -1.36 to -0.14; P=0.02), ICIQ-SF score (MD: -3.79, 95% CI: -5.89 to -1.69; P=0.0004), PFME (MD: 1.93, 95% CI: 0.99 to 2.87; P<0.0001) and pad weight (MD: -1.40, 95% CI: -1.70 to -1.00; P<0.00001).

Conclusions: Current evidence indicated that APFMT might facilitate the recovery of UI after RP according to intermediate-term advantages over CPFMT in terms of pad number, ICIQ-SF score, PFME and pad weight. Further standardized, physiotherapist-guided and well-designed clinical trials conducted by large multicenter and experienced multidisciplinary clinicians are still warranted.

Keywords: Pelvic floor muscle training; Pfilates; hypopressives; meta-analysis; radical prostatectomy.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tau-20-615). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Risk of bias summary of included trials.
Figure 2
Figure 2
Study flow diagram.
Figure 3
Figure 3
The meta-analysis results of CPFMT versus Baseline. CPFMT, conventional pelvic floor muscle training.
Figure 4
Figure 4
The meta-analysis results of APFMT versus Baseline. APFMT, advanced pelvic floor muscle training.
Figure 5
Figure 5
The meta-analysis results of APFMT versus CPFMT. CPFMT, conventional pelvic floor muscle training; APFMT, advanced pelvic floor muscle training.
See this image and copyright information in PMC

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