3; 95% CI, 1.2–1.5).136 Pelvic floor muscle training combined with biofeedback

resulted in greater self-reported continence compared with standard care (selleck pooled absolute risk difference 0.1; 95% CI, 0.05–0.14), but the effect size was not consistent across the studies (P value for heterogeneity, .03).131,136,137 Figure 3 Effects of conservative treatments on continence Inhibitors,research,lifescience,medical compared with regular care (results from randomized controlled clinical trials). RD, absolute risk difference; NPT, negative pad test; SR, self-reported; ICS, completely dry in International Continence … Table 3 Clinical Intervention on Urinary Incontinence (Results From Individual RCTs) Outcome: UI in Community-Dwelling Men. The effects on severity of UI of behavioral interventions Inhibitors,research,lifescience,medical were inconsistent in direction and size compared with usual care. Few RCTs reported significant benefits of behavioral treatments to reduce the risk of UI. The rate of self-reported UI was 70% less after verbal instruction and feedback on contractions of pelvic floor

muscles in 63 patients with bladder Inhibitors,research,lifescience,medical outflow obstruction and diagnosis of symptomatic benign prostatic hyperplasia who underwent transurethral prostatectomy (RR 0.3; 95% CI, 0.1–0.9).138 Pelvic floor muscle training, including a strong postvoid “squeeze out” pelvic floor muscle contraction, biofeedback, and suggestions to change lifestyle, significantly reduced postmicturition dribble and urine loss in men with erectile dysfunction.139 Inhibitors,research,lifescience,medical One large trial showed a substantial benefit of a complex floor rehabilitation program, including patient education, assessment of pelvic floor muscle strength, and visualization of Kegel pelvic floor

muscle training compared with regular care with reduction in severity and pad utilization (RR of using 2 pads per day 0.1; 95% CI, 0.01–0.7).136 Two RCTs examined medical devices on UI in men (Appendix Table 2 [available at www.medreviews.com]).140,141 One small Inhibitors,research,lifescience,medical RCT did not show a relative benefit of a UroLume sphincteric stent inserted cystoscopically to conventional external sphincterotomy Dipeptidyl peptidase in 57 men with spinal cord injury and electromyographic and manometric evidence of external detrusor-sphincter dyssynergia.140 A second small crossover RCT comparing penile compression devices in men 6 months after radical prostatectomy141 did not show differences in resistance index and urine loss during the 4-hour pad test compared with no device. Effects of Clinical Interventions for Urologic Diseases on UI Effects of clinical interventions for urologic diseases on UI142–154 were examined after treatments for prostate cancer143–145,147–150,153,155–157 or benign prostate diseases146,151,152,154 (Appendix Table 2 [available at www.medreviews.com]). Transurethral resection of prostate compared with watchful waiting (1 RCT) did not result in higher rates of persistent UI.