Aug 2026· Psycho-Oncologie· Vol 20· 0 citations· 21 references
TL;DR
Low certainty evidence suggests that selected adjuncts may improve specific continence outcomes when added to PFME, and larger multicenter trials should use standardized continence definitions, common follow-up points, and validated psychological and quality-of-life measures.
Abstract
Background: Urinary incontinence (UI) is a common complication after radical prostatectomy and can affect daily functioning, social participation, emotional well-being, and quality of life. Pelvic floor muscle exercise (PFME) is a first-line conservative intervention, but the added value of combining PFME with other rehabilitation modalities remains uncertain. This review evaluated continence outcomes and explored reported quality-of-life and psychosocial outcomes. Methods: CNKI, WanFang, the Chinese Biomedical Literature Database, CENTRAL, Embase, Web of Science, and PubMed were searched for randomized controlled trials published from January 2000 to June 2025. Eligible studies compared a PFME-based combined intervention with PFME alone after radical prostatectomy. Continuous outcomes were synthesized using mean differences (MDs) or standardized mean differences (SMDs), and continence-recovery events were synthesized using risk ratios (RRs) based on the original studies' definitions. Leave-one-out analyses assessed robustness. Certainty was evaluated using GRADE; heterogeneous quality-of-life and psychosocial outcomes were summarized narratively. Results: Eleven studies contributed 839 participants to the relevant pairwise comparisons. Pooled estimates favored PFME plus acupuncture for 1-hour pad-test leakage (SMD = −1.65, 95% CI −2.00 to −1.30), PFME plus electrical stimulation for International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI SF) scores (SMD = −0.85, 95% CI −1.20 to −0.50), PFME plus biofeedback for continence recovery (RR = 1.49, 95% CI 1.24 to 1.79), and PFME plus vibratory therapy for 24-hour pad-test leakage (MD = −17.10 g, 95% CI −20.39 to −13.81). Certainty was low for the continuous outcomes and very low for continence recovery. Leave-one-out findings were stable except for vibratory therapy, for which removal of the dominant study rendered the estimate non-significant. Two studies reported heterogeneous quality-of-life or psychosocial outcomes; no dedicated psychological outcome could be pooled. Conclusions: Low certainty evidence suggests that selected adjuncts may improve specific continence outcomes when added to PFME. Because each adjunct was evaluated using a different outcome and no head-to-head evidence was available, the modalities cannot be ranked. The psychological effects of improved continence also remain uncertain. Larger multicenter trials should use standardized continence definitions, common follow-up points, and validated psychological and quality-of-life measures.
AIM
This paper aims to evaluate the effects of online pelvic floor muscle training on urinary incontinence frequency, symptom severity, quality of life and adherence across defined female life stages.
BACKGROUND
Urinary incontinence is a significant public health issue affecting women's physical and mental well-being.
DESIGN
The paper is designed as a systematic review and meta-analysis of randomized controlled trials.
REVIEW METHODS
Nine databases were searched for RCTs of online PFMT in women with UI. Outcomes included UI incidence, symptom severity, quality of life and compliance. Data extraction, risk-of-bias (RoB 2) and GRADE assessment were performed. Random-effects meta-analyses used RevMan 5.4.
RESULTS
Sixteen studies were included. Online pelvic floor muscle training significantly reduced postpartum urinary incontinence incidence (RR = 0.56; 95% CI: 0.38 to 0.82) and symptom severity (SMD = -0.25; 95% CI: -0.45 to -0.05), but not in elderly patients (SMD = -0.12; 95% CI: -0.25 to 0.02). Exercise compliance improved in both subgroups. No significant difference was found in quality of life. Moderate-to-high heterogeneity was observed.
CONCLUSIONS
Online pelvic floor muscle exercise may improve urinary incontinence outcomes across different life stages. In postpartum women, it reduces incontinence incidence, alleviates symptom severity and enhances training compliance, whereas in elderly patients, its benefit is limited to improved compliance.
Yu Wang, Hailian Zhang, Jinyang Wang et al.· International Journal of Nur...· 0 citations
INTRODUCTION
Urinary incontinence is one of the most common functional complications following curative treatment for localized prostate cancer, with incidence varying across treatment modalities.
OBJECTIVE
To compare the incidence of urinary incontinence following radical prostatectomy versus radiotherapy or brachytherapy.
METHODS
A systematic review and meta-analysis was conducted in accordance with the PRISMA 2020 statement. A literature search was performed in MEDLINE (via PubMed), Embase, and LILACS from database inception through February 2026. Randomized controlled trials and observational studies evaluating urinary incontinence in patients with localized prostate cancer treated with curative intent were included. Risk ratios (RRs) with 95% confidence intervals (CIs) were estimated using a random-effects model (DerSimonian-Laird method). The protocol was registered in PROSPERO (CRD420261345996).
RESULTS
Eighteen studies were included in the qualitative synthesis, and nine comparative studies comprising 10,208 participants were included in the meta-analysis. Radical prostatectomy was associated with a higher risk of urinary incontinence compared with radiotherapy or brachytherapy (RR = 2.74; 95% CI: 2.03-3.68; P < .001). Substantial heterogeneity was observed across studies (I2 = 80.3%). Sensitivity analyses showed consistent results, and no evidence of publication bias was identified.
CONCLUSIONS
Radical prostatectomy is associated with a higher risk of urinary incontinence compared with radiotherapy modalities in patients with localized prostate cancer. These findings highlight the importance of incorporating functional outcomes into shared decision-making.
A. Amaris Vanegas, D. Cabrera Díaz, J. Salgar Prada et al.· Actas Urológicas Españolas· 0 citations
Pelvic floor muscle training (PFMT) is recommended as a first-line treatment for urinary incontinence (UI); however, treatment adherence among women with UI remains suboptimal. The effectiveness of mobile applications in delivering PFMT for women with UI is not yet well established. This study aimed to evaluate the effects of app-based PFMT interventions on adherence, symptom severity, quality of life, and patient global impression of improvement (PGI-I).
PubMed, Cochrane Library, Scopus, EMBASE, and Web of Science were systematically searched to identify relevant studies published up to February 11, 2026. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated.
A total of 12 randomized controlled trials (RCTs) including 1,647 participants (mobile app group: 823; usual care group: 824) were included. The meta-analysis demonstrated that, compared with usual care, mobile app–based interventions significantly reduced the severity of UI (MD = −1.93, 95% CI: −2.87, −0.98;
P
< 0.0001) and the frequency of incontinence episodes (MD = −2.28, 95% CI: −3.62, −0.94;
P
= 0.0008). In addition, these interventions improved adherence (RR = 1.42, 95% CI: 1.26, 1.59;
P
< 0.00001), PGI-I (RR = 3.79, 95% CI: 1.27, 11.29;
P
= 0.02), and quality of life (MD = −2.78, 95% CI: −4.43, −1.14;
P
= 0.0009).
This meta-analysis suggests that mobile app-based PFMT interventions may serve as an adjunctive approach to improve adherence and patient-reported outcomes among women with UI. However, the magnitude of symptom improvement may be below the threshold of clinical importance, and the certainty of evidence remains low. Mobile applications should therefore complement rather than replace supervised PFMT, particularly for women requiring individualized rehabilitation and objective functional assessment.
Systematic review registration:
https://www.crd.york.ac.uk/PROSPERO/view/CRD420261472595
, identifier CRD420261472595.
Wenjing Zhao, Xiuxiu Cui, Lu Bai· Frontiers in Public Health· 0 citations
PURPOSE
Erectile dysfunction (ED) is a prevalent and distressing consequence of radical prostatectomy (RP) and radiotherapy (RT) for prostate cancer, profoundly impacting quality of life. Despite a wide array of available interventions, their comparative effectiveness remains uncertain in the absence of head-to-head trials.
MATERIALS AND METHODS
We conducted a systematic review and network meta-analysis (NMA) of studies evaluating medical interventions for ED following RP or RT. MEDLINE, Embase, and Scopus were searched for eligible studies. Risk of bias (RoB) was assessed using the Cochrane RoB 2 and ROBINS-I tools. A random-effects NMA was performed, with efficacy expressed as odds ratios (ORs) and 95% confidence intervals (CIs). The certainty of evidence was evaluated using the GRADE framework. The primary outcome was recovery of erectile function, assessed using validated measures or the proportion achieving successful intercourse.
RESULTS
Forty-one studies (n=4,157 participants) met inclusion criteria. Following RP, combination therapies were most effective: tadalafil plus intraurethral alprostadil gel (OR 24.8), tadalafil plus vacuum erection device (OR 12.3), and tadalafil plus low-intensity shockwave therapy (OR 8.2) demonstrated the highest odds of functional recovery versus placebo. Following RT, on-demand tadalafil was the most effective intervention (OR 8.0). Pooled analysis of RP studies showed a significant mean improvement in International Index of Erectile Function scores favouring active interventions over control (mean difference 4.5, 95% CI: 2.4-6.5, I²=62%), with longer intervention duration associated with greater improvement. Overall certainty of evidence was low to very low due to RoB, imprecision, and inconsistency.
CONCLUSIONS
Combination therapies appear most effective for ED recovery after RP, while on-demand phosphodiesterase type 5 inhibitors are most efficacious after RT. These findings provide novel comparative evidence; however, cautious clinical application and further high-quality research are warranted.
Setegn Eshetie, Omena Ejekpokpo, Megan Charlick et al.· The World Journal of Men's H...· 0 citations
Urinary incontinence (UI) is a highly prevalent disorder that significantly impacts women’s daily activities and social life. While pelvic floor muscle exercise (PFME) is recommended as the first-line management approach, there is increasing recognition that combining exercise-based interventions with educational support may enhance clinical outcomes. A quasi-experimental study was conducted involving 100 women, who were divided equally into two groups (n = 50). At baseline, both groups were comparable regarding age, medical history, gynecological history, and occupation (P > 0.05). Outcomes were measured and compared pre- and post-intervention. Post-intervention, the experimental group demonstrated significant improvements in body mass index and waist-to-hip ratio (P < 0.001), whereas the control group showed no significant changes. Furthermore, UI symptoms, particularly leakage triggered by coughing, sneezing, or physical activity, were almost entirely resolved in the intervention group (P < 0.001), yielding very large effect sizes. The intervention group also experienced significant reductions in anxiety, avoidance behaviors, and leakage triggers. Neither medication (42%, 34%), rectocele repair (22%, 28%), nor cystocele repair (24%, 32%) in the control and intervention groups, respectively, led to satisfactory or complete improvement. The combination of PFME and educational support effectively improves physical metrics and alleviates the symptoms and psychological burden of severe UI.
Zhino Raouf Ali, A. Kumait· UHD Journal of Science and T...· 0 citations