Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov;40(11):2617-2626.
doi: 10.1007/s00345-022-04146-5. Epub 2022 Sep 15.

A systematic review of treatment options for post-prostatectomy incontinence

Alexander Canning  1 , Nicholas Raison  2 , Abdullatif Aydin  2 , Samy Cheikh Youssef  3 , Shamim Khan  2 , Prokar Dasgupta  2 , Kamran Ahmed  2
Affiliations

A systematic review of treatment options for post-prostatectomy incontinence

Alexander Canning et al. World J Urol. 2022 Nov.

Abstract

Purpose: Urinary incontinence remains common in men after prostatectomy. Current guidance suggests early corrective surgery to those that are still incontinent after trying Pelvic Floor Muscle Therapy, however, other treatments are now available. This review aims to evaluate all currently available treatment options for men with post-prostatectomy incontinence (PPI).

Methods: A search of MEDLINE and CENTRAL databases on 2/2/2021 produced 879 articles. Any study evaluating incontinence before and after a treatment protocol was eligible for inclusion. After screening, 17 randomized control trials were included, and pre-defined data points were collected. Due to heterogeneity, pooled analysis was not possible, and a descriptive synthesis was produced in accordance with PRISMA guidelines. Cochrane Risk of Bias (RoB) tool was used to evaluate all studies. The search protocol and methods for this study was registered on the PROSPERO database before the search began, ID:(CRD42021229749).

Results: 3/17(18%) of studies focussed on pharmacotherapy, 2/17(12%) on vibration therapies, 8/17(47%) on pelvic floor muscle therapy (PFMT), 3/17(18%) on electrical stimulation (ES), and 1/17 (6%) on extracorporeal magnetic innervation (ExMI) as their main intervention. The use of Duloxetine, Solifenacin, PFMT, ES, and ExMI all show effective reduction in incontinence in men suffering from PPI. No study in this review evaluated surgical managements for PPI.

Conclusion: A large number of treatments are available for PPI using an array of different methods. For this reason, a variety of treatments could be considered before early invasive procedures, to prevent unnecessary surgery and its associated negative complications.

Keywords: Incontinence; PPI; Post-prostatectomy; Prostate; Prostatectomy; Urology.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow diagram showing the process of study selection
Fig. 2
Fig. 2
Risk of Bias assessment
See this image and copyright information in PMC

References

    1. Litwin MS, Melmed GY, Nakazon T. Life after radical prostatectomy: a longitudinal study. J Urol. 2001;166(2):587–592. doi: 10.1016/S0022-5347(05)65989-7. - DOI - PubMed
    1. Fowler FJ, Jr, Barry MJ, Lu-Yao G, Wasson J, Roman A, Wennberg J. Effect of radical prostatectomy for prostate cancer on patient quality of life: results from a Medicare survey. Urology. 1995;45(6):1007–1013. doi: 10.1016/S0090-4295(99)80122-8. - DOI - PubMed
    1. Katz G, Rodriguez R. Changes in continence and health-related quality of life after curative treatment and watchful waiting of prostate cancer. Urology. 2007;69(6):1157–1160. doi: 10.1016/j.urology.2007.02.003. - DOI - PubMed
    1. Turner DA, Shaw C, McGrother CW, Dallosso HM, Cooper NJ. The cost of clinically significant urinary storage symptoms for community dwelling adults in the UK. BJU Int. 2004;93(9):1246–1252. doi: 10.1111/j.1464-410x.2004.04806.x. - DOI - PubMed
    1. Nahon I, Dorey G, Waddington G, Adams R. Systematic review of the treatment of post-prostatectomy incontinence. Urol Nurs. 2006;26(6):461–475. - PubMed

Publication types