Pelvic floor muscle training for conservative treatment of urinary incontinence and erectile dysfunction after radical prostatectomy: a review of literature

Gytis Makarevičius 1

Faculty of Medicine, Vilnius University, Vilnius, Lithuania


Both, urinary incontinence (UI) and erectile dysfunction (ED) reduce person’s quality of life. Current research shows, that pelvic floor muscle training (PFMT) might lessen pelvic dysfunction symptoms.

Aim: To present the current epidemiology of pelvic floor muscle dysfunction in radical prostatectomy (RP) patients and examine the current literature concerning PFMT in alleviating UI and ED in RP patients.

Materials and methods: Cochrane, Google Scholar and PubMed were searched for articles using the terms “pelvic floor dysfunction”, “urinary incontinence”, “erectile dysfunction” in combination with “prevalence”, “epidemiology”, “statistics”, “burden” and “pelvic floor muscle training” „conservative treatment“ in combination with “radical prostatectomy”, “erectile dysfunction”, “urinary incontinence”, “pelvic floor dysfunction” and included studies from 2010 to February of 2022. Only full text articles were included. Paediatric studies were excluded.

Results: The prevalence of UI among patients who underwent RP varies from 2 to 66%. The prevalence of ED ranges from 10 to 46 % 12 months post RP. Pelvic floor rehabilitation after radical prostatectomy is recommended by the European Association of Urology as a method for UI management for patients after RP. Supervised, high-volume and biofeedback incorporating PFMT seems to be useful in reducing post prostatectomy UI. PFMT is also showed to be beneficial for the treatment of ED.

Conclusions:      UI and ED after RP are common. Research on the effectiveness of PFMT for UI and ED raises hope, however, data is highly inconsistent due to methodological disparities.

Keywords: radical prostatectomy, pelvic floor dysfunction, urinary incontinence, erectile dysfunction, pelvic floor muscle training.