Conservative management for post prostatectomy urinary incontinence (Cochrane Review)

A substantive amendment to this systematic review was last made on 23 January 2001. Cochrane reviews are regularly checked and updated if necessary.

Background: Urinary incontinence after prostatectomy is a common problem. Conservative management of this condition includes pelvic floor muscle training, biofeedback, electrical stimulation using a rectal electrode, transcutaneous electrical nerve stimulation, or a combination of methods. Conservative management is often combined with lifestyle adjustments including: decreased or elimination of caffeine, physical exercise, cessation of smoking, and bladder retraining

Objectives: To assess the effects of conservative management for urinary incontinence after transurethral, suprapubic, radical retropubic or perineal prostatectomy.

Search strategy: The Cochrane Incontinence Group's trials register, Medline, Cinahl, Embase, PsycLit (all up to January 2001) and ERIC all up to January 1999, and reference lists of relevant articles. We contacted investigators to locate studies and we handsearched the following conference proceedings: American Urological Association (1989-2000); Society of Urologic Nurses and Associates (1991-2001); Wound Ostomy and Continence Nurses (1996-2000); and International Continence Society (1980-2000). Date of most recent searches: January 2001.

Selection criteria: Randomised or quasi-randomised trials which evaluated conservative management aimed at improving urinary continence after prostatectomy.

Data collection and analysis: Two reviewers independently assessed the methodological quality of studies and abstracted data from included trials onto a standard form.

Main results: Only six randomised trials were identified which included 381 men, each evaluating different treatments, five studying men after radical prostatectomy and one post transurethral prostatectomy. The trials were of moderate quality and data were not available for many of the pre-stated outcomes. Confidence intervals for both dichotomous and continuous data were wide; it was not possible to reliably identify or rule out a useful effect. Men's symptoms tended to improve over time, irrespective of management.

Reviewers' conclusions: The value of the various approaches to conservative management of post prostatectomy incontinence remains uncertain. Further well designed trials are needed.

Citation: Moore KN, Cody DJ, Glazener CMA. Conservative management for post prostatectomy urinary incontinence (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

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This is an abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).

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