Preoperative Pelvic Muscle Training for Continence Recovery After Prostatectomy: Yet Another Meta‐Analysis?

Introduction: Urinary incontinence is a common complication after radical prostatectomy. Several meta-analyses have evaluated the effectiveness of pelvic floor muscle training (PFMT) for continence recovery, but their findings are inconsistent, and not all include all relevant studies. This meta-analysis aims to address these gaps. Objectives: The study aims to summarize evidence on the effectiveness of preoperative PFMT, with or without biofeedback, on continence recovery post-prostatectomy. Materials and Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. The PICO framework was used: Patients undergoing radical prostatectomy, Intervention: preoperative PFMT, Comparison: any postoperative intervention or monitoring, Outcome: continence recovery. Studies were sourced from PubMed, CINAHL, Scopus, Web of Science, and PEdro. Quality was assessed using the PEdro scale, and statistical analysis was performed using a random effect model. Results: Six studies were included. Preoperative PFMT did not significantly improve continence recovery 1 month post-surgery (odds-ratio 2.01, 95% CI [0.94–4.31], p = 0.37). However, a significant improvement was observed 3 months post-surgery (odds-ratio 1.52, 95% CI [1.05–2.20], p = 0.03). No significant differences were found at 6 months (odds-ratio 1.28, 95% CI [0.85–1.94], p = 0.95) and twelve months (odds-ratio 0.73, 95% CI [0.43–1.23], p = 0.32). Conclusions: Preoperative PFMT may improve continence recovery 3 months post-surgery but not at one, six, or twelve months. The study highlights the need for standardized assessment criteria and further research on robotic-assisted prostatectomy. The innovative aspect of this study lies in its conservative inclusion criteria and focus on preoperative PFMT's potential benefits. Clinical Trial Registration: Not applicable. This study did not require clinical trial registration because it is a systematic review and meta-analysis of previously published studies.