Efficacy of Pelvic Floor Exercise for Post-prostatectomy Incontinence: Systematic Review and Meta-analysis

Abstract

To determine the effect of pelvic floor muscle exercise (PFME) for post-prostatectomy urinary incontinence (PPUI), which has a major impact on the quality of life of patients undergone radical prostatectomy (RP). A systematic search was conducted in the PubMed, Embase, and Cochrane Library databases from the inception of each database until April 2021. We performed a meta-analysis separately using the number of patients achieving urinary continence as binary data, and the patients' ICIQ-SF scores as continuous data. Odds ratios (ORs) and mean difference (MD) with 95% confidence intervals (CI) and a random-effects model were utilized to adequately analyze the overall recovery of UI. We performed a risk of bias evaluation on the included studies using the RoB 2 tool. Twenty-one studies met our selection criteria for quantitative synthesis. Eight studies were on the effects of PFME, and 13 studies were on the effects of assistant interventions added to PFME. The overall continence OR in the meta-analysis for PFME vs no-PFME was 2.971 (95% CI: 1.278, 6.907). The overall ICIQ-SF score in the meta-analysis for PFME vs no-PFME was -1.012 (95% CI: -2.379, 0.355). In case of assistant interventions added to PFME, the overall continence OR in the meta-analysis for assistant interventions vs conventional PFME only was 2.128 (95% CI: 1.357, 3.336). In our study, a positive effect of PFME on the recovery of PPUI was observed. However, more research with higher quality is needed to confirm the real efficacy of PFME.