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Yu K, Bu F, Jian T, Liu Z, Hu R, Chen S, Lu J. Urinary incontinence rehabilitation of after radical prostatectomy: a systematic review and network meta-analysis. Front Oncol 2024; 13:1307434. [PMID: 38584666 PMCID: PMC10996052 DOI: 10.3389/fonc.2023.1307434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/27/2023] [Indexed: 04/09/2024] Open
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.
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Affiliation(s)
- Kai Yu
- Department of Urology, The First Hospital of Jilin University, Changchun, China
| | - Fan Bu
- Department of Plastic and Aesthetic Surgery, The First Affiliated Hospital of Jilin University, Changchun, China
| | - Tengteng Jian
- Department of Urology, The First Hospital of Jilin University, Changchun, China
| | - Zejun Liu
- Department of Urology, The First Hospital of Jilin University, Changchun, China
| | - Rui Hu
- Department of Urology, The First Hospital of Jilin University, Changchun, China
| | - Sunmeng Chen
- Department of Urology, The First Hospital of Jilin University, Changchun, China
| | - Ji Lu
- Department of Urology, The First Hospital of Jilin University, Changchun, China
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Lawen T, Ilie G, Mason R, Rendon R, Spooner J, Champion E, Davis J, MacDonald C, Kucharczyk MJ, Patil N, Bowes D, Bailly G, Bell D, Lawen J, Wilke D, Kephart G, Rutledge RDH. Six-Month Prostate Cancer Empowerment Program (PC-PEP) Improves Urinary Function: A Randomized Trial. Cancers (Basel) 2024; 16:958. [PMID: 38473319 DOI: 10.3390/cancers16050958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Purpose: This is a secondary analysis examining a six-month home-based Prostate Cancer-Patient Empowerment Program (PC-PEP) on patient-reported urinary, bowel, sexual, and hormonal function in men with curative prostate cancer (PC) against standard of care. Methods: In a crossover clinical trial, 128 men scheduled for PC surgery (n = 62) or radiotherapy with/without hormones (n = 66) were randomized to PC-PEP (n = 66) or waitlist-control and received the standard of care for 6 months, and then PC-PEP to the end of the year. PC-PEP included daily emails with video instructions, aerobic and strength training, dietary guidance, stress management, and social support, with an initial PFMT nurse consultation. Over 6 months, participants in the PC-PEP received optional text alerts (up to three times daily) reminding them to follow the PFMT video program, encompassing relaxation, quick-twitch, and endurance exercises; compliance was assessed weekly. Participants completed baseline, 6, and 12-month International Prostate Symptom Score (IPSS) and Expanded Prostate Cancer Index Composite (EPIC) questionnaires. Results: At 6 months, men in the PC-PEP reported improved urinary bother (IPSS, p = 0.004), continence (EPIC, p < 0.001), and irritation/obstruction function (p = 0.008) compared to controls, with sustained urinary continence benefits at 12 months (p = 0.002). Surgery patients in the waitlist-control group had 3.5 (95% CI: 1.2, 10, p = 0.024) times and 2.3 (95% CI: 0.82, 6.7, p = 0.11) times higher odds of moderate to severe urinary problems compared to PC-PEP at 6 and 12 months, respectively. Conclusions: PC-PEP significantly improves lower urinary tract symptoms, affirming its suitability for clinical integration alongside established mental health benefits in men with curative prostate cancer.
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Affiliation(s)
- Tarek Lawen
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Gabriela Ilie
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Radiation Oncology, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Ross Mason
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Ricardo Rendon
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Jesse Spooner
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Emmi Champion
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Jessica Davis
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Cody MacDonald
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | | | - Nikhilesh Patil
- Department of Radiation Oncology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - David Bowes
- Department of Radiation Oncology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Greg Bailly
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - David Bell
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Joseph Lawen
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Derek Wilke
- Department of Radiation Oncology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - George Kephart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 4R2, Canada
- School of Health Administration, Dalhousie University, Halifax, NS B3H 4R2, Canada
- School of Nursing, Umeå University, 901 87 Umeå, Sweden
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Zhang Y, Hou S, Qi Z, Wu S, Zhu K, Wang W. Non-pharmacological and nonsurgical interventions in male urinary incontinence: A scoping review. J Clin Nurs 2023; 32:6196-6211. [PMID: 37161602 DOI: 10.1111/jocn.16749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/10/2023] [Accepted: 04/25/2023] [Indexed: 05/11/2023]
Abstract
AIMS To describe and synthesize non-pharmacological and nonsurgical interventions for male urinary incontinence from the existing literature. METHODS A scoping review was conducted following the methodology suggested by Arksey and O'Malley: (1) identification of the research questions; (2) identification of relevant studies using a three-step search recommended by JBI: an initial search within PubMed and CINAHL, a comprehensive literature search within PubMed, CINAHL, EMBASE, PsycINFO, Cochrane Library, and literature search of references lists; (3) study selection; (4) data extraction and charting; (5) collation, summarization, and reporting of the results. The PRISMA-ScR Checklist was used to report. RESULTS A total of 4602 studies were identified, of which 87 studies were included. Approximately 78% were randomized controlled trials. More than 88% of the participants were men with prostate cancer. Exercising pelvic floor muscles 30 times per day for 12 weeks was the most frequently reported. Parameters of electrical stimulation were typically set up to 50 Hz and 300 μs for frequency and width of pulse, respectively, and lasted for 15 min. Pure pelvic floor muscle training, Pilates, Yoga, whole body vibration, diaphragm/abdominal muscle training, micturition interruption exercise, acupuncture, and auriculotherapy showed positive effects on reducing urinary incontinence. CONCLUSION The findings suggested implementing pelvic floor muscle training alone before or after surgery can both prompt the recovery of continence in men after prostate cancer surgery. The decision to use biofeedback or electrical stimulation to enhance the therapeutic effect of pelvic floor muscle training should be approached with caution. More rigorous designed studies are needed to validate the effectiveness of Traditional Chinese Medicine techniques and diverse novel methods. RELEVANCE TO CLINICAL PRACTICE Physicians and nurses need to be up to date on the latest evidence-based non-pharmacological and nonsurgical interventions in male urinary incontinence and select appropriate interventions based on available medical resources and patient preferences.
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Affiliation(s)
- Ying Zhang
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
- Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Sijia Hou
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
- Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Ziyi Qi
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
- Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Siyuan Wu
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
- Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Keping Zhu
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Wei Wang
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
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Yang JM, Ye H, Long Y, Zhu Q, Huang H, Xie HY, Luo Y, Zhong YB, Chen J, Wang MY. Effect of pelvic floor muscle training on urinary incontinence after radical prostatectomy: An umbrella review of meta-analysis and systematic review. Clin Rehabil 2023; 37:494-515. [PMID: 36305082 DOI: 10.1177/02692155221136046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To analyse the specific exercise effects of pelvic floor muscle training (PFMT) with or without biofeedback or electrical stimulation on urinary incontinence rehabilitation after radical prostatectomy. DATA SOURCES We searched PubMed, Embase, Cochrane Database of Systematic Reviews, Web of Science and Scopus databases for systematic reviews and meta-analyses on PFMT for urinary incontinence after radical prostatectomy from inception to 3 October 2022. REVIEW METHODS Two authors independently extracted key data from the included studies. The methodological quality of the included studies was assessed using the A Measure Tool to Assess Systematic Reviews-2 checklist. Grading of Recommendations Assessment Development and Evaluation was used to evaluate the quality of the outcomes. RESULTS A total of 18 studies with 29,925 patients were included, all of which were of critically low methodological quality. Biofeedback therapy seemed to show additional benefits compared to PFMT alone; however, the adjunctive role of electrical stimulation remained more controversial due to the lack of strong evidence. Preoperative PFMT sometimes, but not always, showed the potential to improve urinary incontinence. PFMT with the guidance of a therapist could bring some benefits to the patient and was more acceptable to the patient, but consumed some medical resources. CONCLUSIONS PFMT has a good effect on improving post-radical prostatectomy incontinence in men, and biofeedback can have an additional beneficial effect on patients, especially in the short-term and medium-term. However, there is insufficient evidence to suggest that electrical stimulation is beneficial for patients with urinary incontinence.
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Affiliation(s)
- Jia-Ming Yang
- Department of Rehabilitation Medicine, 477808First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.,74554Gannan Medical University, Ganzhou, Jiangxi, China
| | - Hua Ye
- 74554Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yi Long
- 74554Gannan Medical University, Ganzhou, Jiangxi, China
| | - Qiang Zhu
- Department of Rehabilitation Medicine, 477808First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Hui Huang
- Department of Rehabilitation Medicine, 477808First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Hui-Yong Xie
- 74554Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yun Luo
- Department of Rehabilitation Medicine, 477808First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yan-Biao Zhong
- Department of Rehabilitation Medicine, 477808First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.,Ganzhou Intelligent Rehabilitation Technology Innovation Center, Ganzhou, Jiangxi, China
| | - Jing Chen
- Department of Rehabilitation Medicine, 477808First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Mao-Yuan Wang
- Department of Rehabilitation Medicine, 477808First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.,Ganzhou Key Laboratory of Rehabilitation Medicine, Ganzhou, Jiangxi, China
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Mazur-Bialy A, Tim S, Kołomańska-Bogucka D, Burzyński B, Jurys T, Pławiak N. Physiotherapy as an Effective Method to Support the Treatment of Male Urinary Incontinence: A Systematic Review. J Clin Med 2023; 12:jcm12072536. [PMID: 37048619 PMCID: PMC10095040 DOI: 10.3390/jcm12072536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/05/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Urinary incontinence (UI) is a serious health issue that affects both women and men. The risk of UI increases in men with age and after treatment for prostate cancer and affects up to 32% of men. Furthermore, UI may affect up to 69% of men after prostatectomy. Considering such a high incidence, it is critical to search for effective methods to mitigate this issue. Hence, the present review aims to provide an overview of physiotherapeutic methods and evaluate their effectiveness in treating UI in men. This systematic review was performed using articles included in PubMed, Embase, WoS, and PEDro databases. A total of 6965 relevant articles were found. However, after a risk of bias assessment, 39 studies met the inclusion criteria and were included in the review. The research showed that the available physiotherapeutic methods for treating men with UI, including those after prostatectomy, involve pelvic floor muscle training (PFMT) alone or in combination with biofeedback (BF) and/or electrostimulation (ES), vibrations, and traditional activity. In conclusion, PFMT is the gold standard of UI therapy, but it may be complemented by other techniques to provide a personalized treatment plan for patients. The effectiveness of the physiotherapeutic methods varies from study to study, and large methodological differences make it difficult to accurately compare individual results and draw unequivocal conclusions.
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Affiliation(s)
- Agnieszka Mazur-Bialy
- Department of Biomechanics and Kinesiology, Faculty of Health Science, Jagiellonian University Medical College, Skawińska 8, 31-066 Krakow, Poland
- Correspondence: ; Tel.: +48-012-421-9351
| | - Sabina Tim
- Department of Biomechanics and Kinesiology, Faculty of Health Science, Jagiellonian University Medical College, Skawińska 8, 31-066 Krakow, Poland
| | - Daria Kołomańska-Bogucka
- Department of Biomechanics and Kinesiology, Faculty of Health Science, Jagiellonian University Medical College, Skawińska 8, 31-066 Krakow, Poland
| | - Bartłomiej Burzyński
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Tomasz Jurys
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Natalia Pławiak
- University Hospital in Krakow, Jakubowskiego 2, 30-688 Krakow, Poland
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