NEW YORK (Reuters Health) - Men with urinary incontinence after prostate surgery may benefit from exercises designed to strengthen the pelvic floor muscles, a group of muscles that surround the urethra and rectum, according to a report in BJU International.
"Pelvic floor muscle training with or without biofeedback is useful and should be recommended to improve urinary incontinence after (prostate removal)," Dr. Timothy J. Wilt from the Minneapolis Veterans Affairs Center for Chronic Disease Outcomes Research, Minnesota, told Reuters Health.
Wilt and colleagues systematically reviewed trial data to evaluate pelvic floor muscle training for urinary incontinence after prostate removal.
In one 300-patient trial, pelvic floor muscle training with no biofeedback reduced the time to recovery of continence compared with no training, the authors report.
Similarly, in five trials that enrolled 348 men, pelvic floor muscle training with biofeedback was associated with a greater percentage of men becoming continent or not having continual leakage by 1 to 2 months after surgery (compared with no training), but the benefit was no longer apparent after 3 to 4 months.
In three other trials, the researchers note, biofeedback-enhanced pelvic floor muscle training was no more effective than written or verbal muscle training instruction for any outcome at any evaluation point.
Adding electrical stimulation did not appear to improve pelvic floor muscle training outcomes in one trial of men with persistent urinary incontinence beyond 8 weeks after prostate removal.
"While the evidence indicates support for pelvic floor muscle training," the investigators say, "usage is limited and cannot be applied to every patient" who undergoes this surgery. Men need to be motivated and need to have normal nerve function in the pelvic muscles.
Wilt commented that "future studies should assess whether pelvic floor muscle training and other therapies done prior to surgery can prevent urinary incontinence."
SOURCE: BJU International, July 2007.
