Rehabilitation options for patients with different types of urinary incontinence following transurethral surgery for benign prostatic hyperplasia
TL;DR
Pelvic floor muscle training represents one of the most promising treatment modalities for UI following transurethral surgery for BPH, and further research is needed to clarify optimal rehabilitation strategies, as current evidence remains insufficient to fully assess the efficacy, safety, and potential interactions of different treatment approaches for post-transurethral incontinence in men.
Abstract
Introduction. Transurethral resection of the prostate (TURP) remains the gold standard surgical treatment for benign prostatic hyperplasia (BPH), while various endoscopic enucleation techniques are gaining increasing popularity. Despite the advantages of the minimally invasive transurethral approach, urinary incontinence (UI) remains one of the most significant and undesirable postoperative complications, potentially developing in the postoperative period and substantially impairing daily activities. Objective. To evaluate treatment options for UI following transurethral surgery for BPH. Materials & methods. A systematic review of the PubMed and Elibrary.ru databases was conducted for the period from 1999 to 2026 to identify all relevant studies. The search was limited to publications in Russian and English. Results. Following transurethral surgery for BPH, various UI types may develop, including urge, stress, and mixed incontinence. Reported rates of UI after transurethral procedures for BPH vary considerably across the literature, ranging from 0.5% to 60%. This wide variability reflects the lack of a unified definition and diagnostic approach to this complication. Management of urge urinary incontinence after transurethral surgery for BPH involves a multimodal approach, including anti-inflammatory and antibacterial agents, antimuscarinics, and beta-3 adrenergic receptor agonists; in more severe cases, intradetrusor botulinum toxin injections are employed. For stress urinary incontinence (SUI) associated with the transurethral approach in BPH, first-line therapy consists of pelvic floor muscle training (including biofeedback-guided exercises, magnetic or electrical stimulation). In more severe cases, surgical interventions are considered, such as sling placement or artificial urinary sphincter implantation. Conclusion. Pelvic floor muscle training represents one of the most promising treatment modalities for UI following transurethral surgery for BPH. However, further research is needed to clarify optimal rehabilitation strategies, as current evidence remains insufficient to fully assess the efficacy, safety, and potential interactions of different treatment approaches for post-transurethral incontinence in men.