Urinary incontinence rehabilitation of after radical prostatectomy: a systematic review and network meta-analysis

Kai Yu; Fan Bu; Tengteng Jian; Zejun Liu; Rui Hu; Sunmeng Chen; Ji Lu

doi:10.3389/fonc.2023.1307434

Urinary incontinence rehabilitation of after radical prostatectomy: a systematic review and network meta-analysis

Front Oncol. 2024 Mar 22:13:1307434. doi: 10.3389/fonc.2023.1307434. eCollection 2023.

Authors

Kai Yu¹, Fan Bu², Tengteng Jian¹, Zejun Liu¹, Rui Hu¹, Sunmeng Chen¹, Ji Lu¹

Affiliations

¹ Department of Urology, The First Hospital of Jilin University, Changchun, China.
² Department of Plastic and Aesthetic Surgery, The First Affiliated Hospital of Jilin University, Changchun, China.

Abstract

Purpose: The aim of this study is to provide treatment for patients with urinary incontinence at different periods after radical prostatectomy.

Methods: The PubMed, Embase, Cochrane, and Web of Science were searched for all literature on the effectiveness on urinary control after radical prostate cancer between the date of database creation and 15 November 2023 and performed a quality assessment. A network meta-analysis was performed using RevMan 5.3 and Stata 17.0 software and evaluated using the surface under the cumulative ranking curve.

Results: The results of the network meta-analysis showed that pelvic floor muscle therapy including biofeedback with professional therapist-guided treatment demonstrated better results at 1 month to 6 months; electrical stimulation, biofeedback, and professional therapist guidance may be more effective at 3 months of treatment; professional therapist-guided recovery may be less effective at 6 months of treatment; and combined therapy demonstrated better results at 1 year of treatment. During the course of treatment, biofeedback with professional therapist-guided treatment may have significant therapeutic effects in the short term after surgery, but, in the long term, the combination of multiple treatments (pelvic floor muscle training+ routine care + biofeedback + professional therapist-guided treatment + electrical nerve stimulation therapy) may address cases of urinary incontinence that remain unrecovered long after surgery.

Conclusion: In general, all treatment methods improve the different stages of functional recovery of the pelvic floor muscles. However, in the long term, there are no significant differences between the treatments. Given the cost-effectiveness, pelvic floor muscle training + routine care + biofeedback + professional therapist-guided treatment + electrical nerve stimulation therapy within 3 months and pelvic floor muscle + routine care after 3 months may be a more economical option to treat urinary incontinence.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=331797, identifier CRD42022331797.

Keywords: network meta-analysis; pelvic floor muscle; radical prostatectomy; rehabilitation; urinary incontinence.

Publication types

Systematic Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by Jilin Scientific and Technological Development Program (20200201315JC), Jilin Province Tianhua Health Foundation (J2023JKJ017), and Bethune Urological Oncology Special Grant, Beijing Bethune Charity Foundation (mnzl202022).