To evaluate whether additional pelvic floow muscle training (PFMT), which began before radical prostatectomy and resumes immediately after catheter removal, will significantly improve urinary incontinence after RP.

We reviewed articles obtained from MEDLINE, CENTRAL, EBSCOHost, CINAHL, and Elsevier from July – August 2020, which compared preoperative PFMT with postoperative PMFT or non-PFMT, with continence incidence parameters. There were no restrictions on the definition of incontinence, treatment regimens, and radical prostatectomy surgical approach. The risk of bias was assessed using the Cochrane Risk of Bias Assessment Tool. A meta-analysis was also carried out to pool the effect estimates.

A literature search on five electronic databases found 883 articles (first hit), and we found 285 similar articles. For 598 remaining articles, we screened and found that only 17 articles were eligible. We independently conducted a full-text analysis of the remaining 17 articles and found five articles that did not fit the PICOS that we specified in this meta-analysis. We included 12 articles in this review and 11 articles in quantitative synthesis (meta-analysis)

The PFMT initiated preoperatively significantly reduced the incidence of persistent urinary incontinence at 1, 3, and 6 months postoperatively with an OR of 0.58 (95% CI, 0.41–0.81), 0.57 (95% CI, 0.43–0.74), and 0.38 (95% CI, 0.17-0.83). There was no difference in improvement in patients' incontinence at 12 months postoperatively [OR = 1.31 (95% CI, 0.65-2.63)].

PFMT initiated before radical prostatectomy significantly reduced the incidence of urinary incontinence in the first, third, and sixth months postoperatively. At 12 months postoperatively, additional preoperative PFMT did not cause a significant difference in the incidence of urinary incontinence.