Cochrane Summaries

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Conservative management for men with urinary incontinence after prostate surgery

Anderson CA, Omar M, Campbell SE, Hunter KF, Cody JD, Glazener CMA
Published Online: 
20 January 2015

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.

This record should be cited as: 
Anderson CA, Omar M, Campbell SE, Hunter KF, Cody JD, Glazener CMA. Conservative management for postprostatectomy urinary incontinence. Cochrane Database of Systematic Reviews 2015, Issue 1. Art. No.: CD001843. DOI: 10.1002/14651858.CD001843.pub5
Assessed as up to date: 
5 February 2014