Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, South Korea.
College of Biological Sciences, University of California, Davis, CA.
Urology. 2022 Oct;168:175-182. doi: 10.1016/j.urology.2022.04.023. Epub 2022 May 5.
To determine the effect of pelvic floor muscle exercise (PFME) for post-prostatectomy urinary incontinence (PPUI), which has a major impact on the quality of life of patients undergone radical prostatectomy (RP).
A systematic search was conducted in the PubMed, Embase, and Cochrane Library databases from the inception of each database until April 2021. We performed a meta-analysis separately using the number of patients achieving urinary continence as binary data, and the patients' ICIQ-SF scores as continuous data. Odds ratios (ORs) and mean difference (MD) with 95% confidence intervals (CI) and a random-effects model were utilized to adequately analyze the overall recovery of UI. We performed a risk of bias evaluation on the included studies using the RoB 2 tool.
Twenty-one studies met our selection criteria for quantitative synthesis. Eight studies were on the effects of PFME, and 13 studies were on the effects of assistant interventions added to PFME. The overall continence OR in the meta-analysis for PFME vs no-PFME was 2.971 (95% CI: 1.278, 6.907). The overall ICIQ-SF score in the meta-analysis for PFME vs no-PFME was -1.012 (95% CI: -2.379, 0.355). In case of assistant interventions added to PFME, the overall continence OR in the meta-analysis for assistant interventions vs conventional PFME only was 2.128 (95% CI: 1.357, 3.336).
In our study, a positive effect of PFME on the recovery of PPUI was observed. However, more research with higher quality is needed to confirm the real efficacy of PFME.
评估盆底肌锻炼(PFME)对前列腺根治术后尿失禁(PPUI)的影响,因为这对接受前列腺根治术(RP)的患者的生活质量有重大影响。
我们在 PubMed、Embase 和 Cochrane Library 数据库中进行了系统性检索,检索时间从各数据库建立至 2021 年 4 月。我们分别使用实现尿控的患者人数这一二分数据和患者的国际尿失禁咨询委员会尿失禁问卷简表(ICIQ-SF)评分这一连续数据进行了荟萃分析。我们使用比值比(OR)和均数差(MD)及其 95%置信区间(CI)和随机效应模型来充分分析 UI 的总体恢复情况。我们使用 RoB 2 工具对纳入的研究进行了偏倚风险评估。
有 21 项研究符合我们的定量综合选择标准。8 项研究评估了 PFME 的效果,13 项研究评估了辅助干预措施联合 PFME 的效果。荟萃分析中,PFME 与不进行 PFME 相比,整体尿控的 OR 为 2.971(95% CI:1.278,6.907)。荟萃分析中,PFME 与不进行 PFME 相比,ICIQ-SF 评分的 MD 为-1.012(95% CI:-2.379,0.355)。在联合辅助干预措施的情况下,辅助干预措施与单纯常规 PFME 相比,整体尿控的 OR 为 2.128(95% CI:1.357,3.336)。
在我们的研究中,观察到 PFME 对恢复 PPUI 有积极影响。然而,需要更多高质量的研究来证实 PFME 的真实疗效。