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Conservative management for postprostatectomy urinary incontinence

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  • Background information The prostate is a male sex gland that surrounds the outlet of the bladder. Two main diseases of the prostate (cancer of the prostate, and benign (non-cancerous) prostatic enlargement) can be treated by surgery but some men suffer leakage of urine (urinary incontinence) afterwards. Conservative treatments of the leakage such as pelvic floor muscle training with or without biofeedback or anal electrical stimulation are thought to help men control this leakage. The main findings of the review The review of trials found that there was conflicting evidence about the benefit of therapists teaching men to contract their pelvic floor muscles for either prevention or treatment of urine leakage after radical prostate surgery for cancer. However, information from one large trial suggested that men do not benefit from seeing a therapist to receive pelvic floor muscle training after transurethral resection (TURP) for benign prostatic enlargement. Overall, there was insufficient evidence to demonstrate a beneficial effect from pelvic floor muscle training. Of three external compression devices tested, one penile clamp seemed to be better than the others. Adverse effects This one penile clamp needed to be used cautiously because of safety risks. Any limitations of the review In future updates it may be worth considering two separate reviews, looking separately at 'treatment' and 'prevention' trials. More research that is of better quality is also needed to assess conservative management.

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    Research Material
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    © 2015 Anderson, C.A. et al. This version of this article is open access and can be downloaded and shared. The original authors and source must be cited.
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    • Anderson C.A., Omar M.I., Campbell S. E., Hunter K. F., Cody J. D., Glazener C. M. A. 2015. Conservative management for postprostatectomy urinary incontinence. Cochrane Database of Systematic Reviews. doi: 10.1002/14651858.CD001843.pub5