Table 3.
Study and patient characteristics selected from the literature analysis
First author | LUTS | No. of patients | Study design | Level of evidence | Intervention | Start of treatment (after RP/RT) | Active treatment mean follow‐up |
---|---|---|---|---|---|---|---|
Conservative management | |||||||
Pelvic floor muscle training (PFMT) | |||||||
Campbell et al. 72 | UI | 1937 | Systematic review | 2A | Conservative management: PFMT | Varied (post‐surgery) | Varied |
Centemero et al. 73 | UI | 118 | RCT | 1B | Pre and post‐op PFMT vs. Post‐op PFMT | 30 d before surgery vs. at catheter removal | 3 mo |
Centemero et al. 74 | UI | 143 | RCT | 1B | Structured PFMT pre‐op vs. post‐op PFMT | 30 and 15 d pre‐op | 3 mo |
Dieperink et al. 75 | Urinary, bowel, sexual, and hormonal symptoms | 161 | RCT | 1B | TG guided sessions vs. standard care | Pre and 4 wk post RT/ADT | 20 wk |
Dubbelman et al. 76 | UI | 70 | RCT | 1B | Physiotherapist‐guided PFMT vs. information only folder | Immediately after surgery | 26 wk = 6 mo |
Faithfull et al. 77 | LUTS | 71 | Case series | 4 | Self‐management:
|
≥ 3 mo post RT | 4 mo |
Filocamo et al. 78 | UI | 300 | RCT | 1B | Structured PFMT program vs. no formal instructions re PFMT | After catheter removal post‐RP | 6 mo |
Geraerts et al. 79 | UI | 180 | RCT | 1B | PFMT pre‐op and continued after surgery vs. PFMT post‐op | 3 wk before RP vs. at catheter removal | 6 mo |
Glazener et al. 80 | UI | 787 (2 trials; 411 after RP and 442 after TURP) | RCT | 1B | PFMT with physiotherapist vs. lifestyle advise only (no PFMT info) | 6 wk after surgery | 12 mo |
Goode et al. 81 | UI | 208 | RCT | 1B | Behavioural therapy vs. behavioural therapy + in‐office, dual‐channel electromyograph biofeedback and daily pelvic floor electrical stimulation vs. delayed treatment* | ≥ 1 yr after RP | 12 mo |
Khoder et al. 17 | UI | 911 | Retrospective cohort analysis | 4 |
|
Varied (post‐RP) | Varied |
Lin et al. 76 | UI | 67 | RCT | 1B | PFMT vs. no exercise | At catheter removal after surgery | 6 mo |
Marchiori 18 | UI | 332 | RCT | 1B | Tutored and guided pelvic training program vs. no program (patients asked to perform same PFMT at home) | 1 mo after RP | 12 mo |
Mariotti et al. 19 | UI | 60 | RCT | 1B | PFES + biofeedback vs. control (no treatment) | 7 d after surgery | 6 mo |
Nilssen et al. 83 (based on Overgard subjects) | Urinary, sexual and bowel function | 85 | RCT | 1B | Physiotherapist‐guided PFMT vs. self‐training | Within 12 mo of RP | 12 mo |
Overgard et al. 16 | UI | 85 | RCT | 1B | Physiotherapist‐guided PFMT vs. self‐training | Within 12 mo of RP | 12 mo |
Park et al. 31 | UI | 49 | RCT | 1B | Combined exercise intervention vs. only Kegel exercises | Week 3 after RP | 12 wk |
Patel et al. 84 | UI | 284 | Retrospective cohort analysis | 4 |
Preop Physiotherapist‐guided PFMT vs. information only Post‐op – both groups had Physiotherapist‐guided PFMT |
4 wk pre‐op vs. after surgery | 3 mo |
Ribeiro et al. 85 | UI | 73 | RCT | 1B | PFMT‐biofeedback vs. brief advise on PFMT | 15 d after surgery | 12 mo |
Serdà 86 | UI | 66 | RCT | 1B | PFMT | Time n/a (after RP) | 24 wk |
Tienforti et al. 87 | UI | 32 | RCT | 1B | Training session + BFB, supervised PFMT and structured post‐op programme (+post op control visit) vs. post op info only | 1 d before surgery vs. At catheter removal | 6 mo |
Van Kampen et al. 88 | UI | 102 | RCT | 1B | PFMT vs. placebo | At catheter removal | 1 yr |
Wille et al. 89 | UI | 139 | RCT | 1B | Instructions about PFMT vs. instructions and ES† for 15 min twice daily vs. biofeedback for 15 min twice daily | At catheter removal post RP | 3 mo |
Zahariou et al. 90 | UI | 58 | RCT | 1B | Nurse‐supported structured program vs. information only | At catheter removal after RP | 6 mo |
Oral medication | |||||||
Serotonin‐norepinephrine reuptake inhibitor (Duloxetine) | |||||||
Cornu et al. 91 | Stress UI (SUI) | 31 | RCT | 1B | 80 mg duloxetine daily vs. placebo | >1 yr after RP | 3 mo |
Filocamo et al. 92 | SUI | 112 | RCT | 1B | Duloxetine + rehabilitation vs. rehabilitation | After catheter removal (post RP) for 16 wk | 24 wk |
Neff et al. 93 | Stress UI | 94 | Case series | 4 | Duloxetine 30 mg once a week, then 60 mg thereafter | Not specified (Post‐RP) | 1 mo |
Alpha blockers | |||||||
Jang et al. 94 | Voiding function | 94 | RCT | 1B | Tamsulosin (0.2 mg/day for 7 days) vs. placebo | 3 days after rectal surgery | 7 days |
Oyama et al. 95 | LUTS | 116 | Case series | 4 | Alpha 1‐adrenoceptor antagonists (tamsulosin, silodosin and naftopidil) | ≥ 1 yr after BT | |
Shimizu et al. 96 | LUTS | 105 | Randomised comparative study | 2A | Silodosin 8 mg/day daily for 6 mo | Immediately after BT | 12 mo |
Tsumura et al. 97 | Urinary symptoms | 212 | RCT | 1B | Naftopidil vs. tamsulosin vs. vs. silodosin | 1 d after BT | 12 mo |
Antimuscarinics | |||||||
Zhang et al. 98 | Urinary symptoms | 116 | RCT | 1B | Solifenacin 5 mg for 2 wk vs. placebo | 6 h pre‐surgery and daily post‐surgery | 2 wk |
Phosphodiesterase type 5 inhibitor (PDE5‐I) | |||||||
Gacci et al. 99 | UI | 39 | RCT | 1B | Vardenafil on demand vs. Vardenafil nightly vs. Placebo | Immediately after RP | 12 mo |
Gandaglia et al. 20 | Recovery of sphincter and pelvic floor function | 705 | Review | 4 | No PDE5‐I use vs. On‐demand PDE5‐I use vs. Daily PDE5‐I use | 30 d after surgery | Mean follow up 29 mo |
Other treatments | |||||||
Bonetta and Di Pierro 100 | UTIs | 370 | Randomised comparative study | IIA | Cranberry extract vs. no extract | During RT | 6–7 wk |
Campbell et al. 101 | Urinary symptoms | 112 | Comparative study | IIA | Cranberry juice vs. apple juice 354 ml/day | While receiving RT | 9 wk (incl 7 wk on RT) |
Cowan et al. 102 | Urinary symptoms | 128 | RCT | 1B | Cranberry juice vs. placebo beverage | During and post‐RT | 6 wk |
Matsushita et al. 103 | Urinary symptoms | 54 | Comparative study | IIA | Mecobalamin (Vit B12) vs. no treatment | Pre‐ and post‐RP | 12 mo |
Sommariva et al. 104 | Cystitis | 69 | Case series | 4 | Weekly sodium hyaluronate, 40 mg/50 ml + dexamethasone 32 mg (initial 4 wk) | Post RP and post chemo for bladder cancer | 24 wk |
Tanaka et al. 105 | LUTS | 37 | Comparative study | IIA | Eviprostat vs. no treatment | 3 mo pre and 3 mo post BT | 6 mo |
Containment devices | |||||||
Fader et al. 106 | UI | 80 | Comparative study | IIA | Penile compression devices (clamp) vs. Sheath drainage systems vs. Body‐worn urinals | ≥ 1 yr post‐surgery | 3 mo |
PFMT, Pelvic floor muscle training; BT, Brachytherapy; RT, Radiotherapy; UTI, Urinary tract infection; TG, Therapist guided; mo, month; wk, week; d, day. *Offered treatment after 8 wk but not during study period. †Electrical stimulation.