Effectiveness of electrical stimulation for treating male urinary incontinence after prostatectomy: a meta-analysis and systematic review.

Background: Prostatectomy frequently leads to postoperative urinary incontinence (UI), significantly impairing patients' quality of life. While pelvic floor muscle exercises (PFME) are commonly employed, the efficacy of electrical stimulation (ES) as a non-invasive adjunct remains debated. This systematic review and meta-analysis evaluated the effectiveness of ES combined with PFME versus PFME alone for post-radical prostatectomy UI.

Method: A comprehensive search across PubMed, MEDLINE, EMBASE, Cochrane Library, and ResearchGate identified 10 randomized controlled trials (RCTs) meeting inclusion criteria. Outcomes included 24-hour pad test, International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), quality of life (QOL), and incontinence control rate. Data were analyzed using Review Manager 5.4.1, employing fixed- and random-effects models.

Results: Short-term ES (≤3 months) significantly improved ICIQ-SF scores (MD = - 3.50; 95% CI: - 5.11 to -1.89, p < 0.0001) and doubled incontinence control rates (RR = 2.01; p = 0.01), though no improvement was observed in 24-hour pad test (MD = - 50.07; p = 0.30) or QOL. Conversely, long-term ES (≥6 months) demonstrated marked reductions in urinary leakage via the 24-hour pad test (MD = - 21.64; p = 0.02), but no significant differences in ICIQ-SF scores or control rates compared to PFME alone.

Conclusion: Electrical stimulation therapy can be an effective treatment option for patients with post-RP UI. It can significantly improve UI symptoms in the short term and has a positive impact on reducing urinary leakage in the long term.