Ali Marwan, Hutchison Dylan D, Ortiz Nicolas M, Smith Ryan P, Rapp David E
Department of Urology, University of Virginia Medical Center, Charlottesville, VA, USA.
Transl Androl Urol. 2022 Aug;11(8):1200-1209. doi: 10.21037/tau-22-143.
Urinary incontinence following prostate treatment (IPT) is a common complication with corresponding negative impacts on quality of life. Pelvic floor muscle training (PFMT) is a non-invasive treatment strategy to treat combat this clinical issue, and has been recognized by medical associations globally and increasingly supported by large bodies of literature. Accordingly, many studies demonstrate a significant benefit of pelvic floor muscle training to continence status and quality of life in men with incontinence following prostate treatment. However, related research is limited by variety in treatment regimens, outcome measures, and study designs, with unclear impact on treatment success. We aim to provide a brief overview of pathology and incidence of incontinence following prostate surgery and an understanding how PFMT is currently used to treat and prevent this clinical consequence.
A comprehensive literature search was conducted utilizing PubMed, Medline, and Google Scholar. Search criteria included systematic reviews and randomized control trials published in the year 2000 to present. References of resulting studies were further analyzed to identify further articles of relevance. Keywords searched included: "post-prostatectomy incontinence", "pelvic muscle strengthening", "Benign Prostatic Hyperplasia", and "pelvic floor muscle training". Peer-reviewed publications that demonstrated a novel addition to the existing body of literature on this subject were included.
Upon review of the current research landscape, PFMT is largely supported in treatment of IPT. Analysis of current literature on this subject demonstrates heterogeneity in protocols, measures of treatment success, and patient numbers. Nevertheless, benefits to continence and quality of life are noted across an expansive body of literature and as such, PFMT is therefore recommended as an important part of the treatment algorithm following radical prostatectomy.
PFMT is an important and effective part of the treatment algorithm in the prevention and treatment of IPT. Additional research is needed to more extensively assess PFMT's role in treating this clinical consequence, especially following other prostate surgeries.
前列腺治疗后尿失禁（IPT）是一种常见并发症，对生活质量有相应的负面影响。盆底肌肉训练（PFMT）是一种治疗该临床问题的非侵入性治疗策略，已得到全球医学协会的认可，并越来越多地得到大量文献的支持。因此，许多研究表明，盆底肌肉训练对前列腺治疗后尿失禁男性的控尿状态和生活质量有显著益处。然而，相关研究受到治疗方案、结局指标和研究设计多样性的限制，对治疗成功的影响尚不清楚。我们旨在简要概述前列腺手术后尿失禁的病理和发生率，并了解PFMT目前如何用于治疗和预防这一临床后果。
利用PubMed、Medline和谷歌学术进行全面的文献检索。检索标准包括2000年至今发表的系统评价和随机对照试验。对所得研究的参考文献进行进一步分析，以确定更多相关文章。检索的关键词包括：“前列腺切除术后尿失禁”、“盆底肌肉强化”、“良性前列腺增生”和“盆底肌肉训练”。纳入了对该主题现有文献有新补充的同行评审出版物。
在回顾当前的研究情况时，PFMT在IPT治疗中得到了广泛支持。对该主题当前文献的分析表明，在方案、治疗成功的衡量标准和患者数量方面存在异质性。然而，大量文献都指出了对控尿和生活质量的益处，因此，PFMT被推荐为根治性前列腺切除术后治疗方案的重要组成部分。
PFMT是预防和治疗IPT治疗方案中的重要且有效组成部分。需要进一步研究以更广泛地评估PFMT在治疗这一临床后果中的作用，尤其是在其他前列腺手术后。
