This interdisciplinary, consensus-based guideline addresses urotherapeutic care for male stress urinary incontinence following radical prostatectomy for non-metastatic prostate cancer. The primary aim was to develop structured, evidence-informed recommendations for conservative, non-surgical urotherapeutic interventions before and after surgery in order to reduce post-prostatectomy incontinence, support functional recovery and improve health-related quality of life.

A clinical, non-surgical S2 guideline was developed by a multidisciplinary working group in accordance with established guideline development standards. Systematic literature searches were conducted in PubMed, the Cochrane Library, Google Scholar and Livivo to identify evidence related to post-prostatectomy incontinence, urotherapy, pelvic floor rehabilitation, patient education and conservative management strategies. Clinical studies, systematic reviews and relevant guideline literature were included. Based on the identified evidence, recommendations were formulated through a structured consensus process and classified as strong recommendations, recommendations or open recommendations. The guideline covers urotherapeutic interventions across the full perioperative pathway, including preoperative continence training, postoperative management, rehabilitation and long-term follow-up.

The guideline identifies male stress urinary incontinence as a frequent and highly burdensome complication after radical prostatectomy. Evidence synthesis indicates that early and continuous urotherapeutic intervention is associated with improved continence outcomes and reduced symptom-related distress. Key recommendations include structured preoperative continence training, postoperative guidance on bladder management, supervised pelvic floor muscle training and ongoing urotherapeutic counselling. The guideline emphasises that insufficiently treated post-prostatectomy incontinence negatively affects daily activities, social participation and emotional wellbeing. Conservative, non-surgical urotherapeutic strategies were identified as first-line interventions to support continence recovery and prevent maladaptive coping behaviours.

These findings underline that male stress urinary incontinence after radical prostatectomy requires more than isolated pelvic floor exercises. Effective management depends on structured education, appropriate timing of interventions and continuous professional support. Urotherapy provides a framework for integrating continence training, behavioural strategies and patient education into routine care. Early implementation across care settings may shorten the duration of incontinence and mitigate its psychosocial consequences.

This guideline provides a structured framework for conservative, non-surgical urotherapeutic management of male stress urinary incontinence after radical prostatectomy. Integrating urotherapy into perioperative prostate cancer care supports continence recovery and should be considered an essential component of clinical management.

Wennerberg et al. (2021) Patient experiences of self-care management after radical prostatectomy
Rick et al. (2015) Standard für die Rehabilitation von Patienten mit Prostatakarzinom – ein multidisziplinärer Konsens
NICE (2023) Shared decision making

Continence 19S (2026) 102509
DOI: 10.1016/j.cont.2026.102509