{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:07:44Z","timestamp":1790078864889,"version":"4.0.1"},"reference-count":48,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Urinary incontinence remains one of the most frequent and distressing complications after radical prostatectomy and can substantially affect quality of life. Physiotherapy, particularly pelvic floor muscle training (PFMT), is widely used as part of conservative postoperative management; however, substantial variation exists in patient populations, surgical and perioperative factors, intervention protocols, timing of initiation, adjunctive modalities, outcome definitions, and follow-up. This narrative review summarizes current evidence on pelvic floor rehabilitation after radical prostatectomy, focusing on prehabilitation, PFMT, biofeedback, electrical stimulation, neuromodulation, and emerging modalities such as transfer energy capacitive and resistive (TECAR) therapy. PFMT is the most widely studied conservative physiotherapy intervention and may accelerate early recovery of continence in some patients, although its effects on longer-term continence rates are less certain. The role of biofeedback and electrical stimulation remains unclear because of heterogeneous protocols and inconsistent outcome reporting. Evidence for neuromodulation is limited and should be interpreted according to the specific intervention and study population. TECAR therapy currently lacks direct clinical evidence supporting its efficacy in post-prostatectomy urinary incontinence. Across the literature, differences in continence definitions, intervention content and dose, baseline symptom severity, surgical techniques, timing of treatment, and follow-up complicate direct comparison and may confound observed improvements because spontaneous recovery is common after surgery. Current evidence supports PFMT as a reasonable core component of conservative management after radical prostatectomy, particularly for accelerating early continence recovery, whereas long-term superiority and the added value of adjunctive modalities remain uncertain.<\/jats:p>","DOI":"10.3390\/jcm15187245","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:09:35Z","timestamp":1790075375000},"page":"7245","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Physiotherapy for Urinary Incontinence After Radical Prostatectomy: Current Evidence and Therapeutic Challenges"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6636-7892","authenticated-orcid":false,"given":"Izabela","family":"Mastej-Stawarska","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences and Psychology, University of Rzesz\u00f3w, Al. Tadeusza Rejtana 16C, 35-959 Rzesz\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4619-7705","authenticated-orcid":false,"given":"Edyta","family":"\u0141uszczki","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Psychology, University of Rzesz\u00f3w, Al. Tadeusza Rejtana 16C, 35-959 Rzesz\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0174-7133","authenticated-orcid":false,"given":"Maciej Tomasz","family":"Kochman","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Psychology, University of Rzesz\u00f3w, Al. Tadeusza Rejtana 16C, 35-959 Rzesz\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref_1","first-page":"485","article-title":"Prostate cancer statistics, 2025","volume":"75","author":"Kratzer","year":"2025","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.14740\/wjon1191","article-title":"Epidemiology of prostate cancer","volume":"10","author":"Rawla","year":"2019","journal-title":"World J. Oncol."},{"key":"ref_3","first-page":"229","article-title":"Global cancer statistics2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_4","first-page":"289","article-title":"Non-dietetic environmental risk factors in prostate cancer","volume":"35","year":"2011","journal-title":"Actas Urol. Esp."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1016\/j.mcna.2020.08.007","article-title":"Screening for prostate cancer","volume":"104","author":"Carlsson","year":"2020","journal-title":"Med. Clin. N. Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"106588","DOI":"10.1016\/j.jsbmb.2024.106588","article-title":"PSA, an outdated biomarker for prostate cancer: In search of a more specific biomarker, citrate takes the spotlight","volume":"243","author":"Galey","year":"2024","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_7","first-page":"255","article-title":"Robot-assisted radical prostatectomy","volume":"68","year":"2024","journal-title":"Magy. Onkol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"9733","DOI":"10.3390\/curroncol29120764","article-title":"Salvage Retzius-sparing radical prostatectomy: A review of complications, functional outcomes, and oncologic outcomes","volume":"29","author":"Mason","year":"2022","journal-title":"Curr. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1097\/JU.0000000000003678","article-title":"Same-day discharge vs. inpatient robotic-assisted radical prostatectomy: Complications, time-driven activity-based costing, and patient satisfaction","volume":"210","author":"Cheng","year":"2023","journal-title":"J. Urol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"544","DOI":"10.56434\/j.arch.esp.urol.20227506.80","article-title":"Randomized open trial to assess the effectiveness of guided pelvic floor exercises before robotic radical prostatectomy on improvement of urinary incontinence: Initial results","volume":"75","year":"2022","journal-title":"Arch. Esp. Urol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1590\/s1677-5538.ibju.2019.0238","article-title":"Effects of perioperative pelvic floor muscle training on early recovery of urinary continence","volume":"45","author":"Fornari","year":"2019","journal-title":"Int. Braz. J. Urol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Wang, W., Huang, Q.M., Liu, F.P., and Mao, Q.Q. (2014). Effectiveness of preoperative pelvic floor muscle training for urinary incontinence after radical prostatectomy: A meta-analysis. BMC Urol., 14.","DOI":"10.1186\/1471-2490-14-99"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"207","DOI":"10.3138\/ptc.2017-90","article-title":"A comparative analysis of physiotherapy for stress urinary incontinence after open or robotic-assisted radical prostatectomy","volume":"71","author":"Sehgal","year":"2019","journal-title":"Physiother. Can."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1016\/j.eururo.2010.02.028","article-title":"Preoperative pelvic floor muscle exercise","volume":"57","author":"Centemero","year":"2010","journal-title":"Eur. Urol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"16563","DOI":"10.1007\/s00432-023-05409-3","article-title":"Prehabilitative vs. rehabilitative exercise","volume":"149","author":"Singh","year":"2023","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"436","DOI":"10.5152\/tud.2021.21096","article-title":"Comparison of pelvic floor muscle biofeedback before or after radical prostatectomy on urinary incontinence: A randomized controlled trial","volume":"47","author":"Allameh","year":"2021","journal-title":"Turk. J. Urol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1002\/nau.24247","article-title":"Effect of personalized extracorporeal biofeedback device for pelvic floor muscle training on urinary incontinence after robot-assisted radical prostatectomy: A randomized controlled trial","volume":"39","author":"Oh","year":"2020","journal-title":"Neurourol. Urodyn."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1589\/jpts.30.825","article-title":"Pelvic floor muscle training and electrical stimulation after radical prostatectomy: A randomized controlled trial","volume":"30","author":"Laurienzo","year":"2018","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1001\/jama.2010.1972","article-title":"Behavioral therapy with or without biofeedback and pelvic floor electrical stimulation for persistent postprostatectomy incontinence: A randomized controlled trial","volume":"305","author":"Goode","year":"2011","journal-title":"JAMA"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"41603","DOI":"10.1038\/s41598-025-25567-3","article-title":"Electrical pudendal nerve stimulation versus pelvic floor muscle training with transrectal electrical stimulation for post-radical prostatectomy incontinence: A cohort study","volume":"15","author":"Li","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e2534491","DOI":"10.1001\/jamanetworkopen.2025.34491","article-title":"Electroacupuncture after prostatectomy","volume":"8","author":"Niu","year":"2025","journal-title":"JAMA Netw. Open"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Elhosary, E.A., Ahmed Hamada, H., Ali AlMubali, F., L\u00f3pez-S\u00e1nchez, G.F., and Ahmed, S.M. (2023). Effect of monopolar capacitive resistive radiofrequency in treating stress urinary incontinence: A pilot randomized controlled trial. Front. Psychol., 13.","DOI":"10.3389\/fpsyg.2022.1062363"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Frani\u0107, D., Frani\u0107 Ivani\u0161evi\u0107, M., and Verdenik, I. (2024). Radiofrequency as the new opportunity in treating overactive bladder and urge urinary incontinence: A single-arm pilot study. Medicina, 60.","DOI":"10.3390\/medicina60020197"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"104514","DOI":"10.1016\/j.critrevonc.2024.104514","article-title":"A clinical evaluation of robotic-assisted radical prostatectomy in localized prostate cancer: A systematic review and network meta-analysis","volume":"204","author":"Xu","year":"2024","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1007\/s11701-024-02041-2","article-title":"Reduction of surgical complications via 3D models during robotic-assisted radical prostatectomy: Review of current evidence and meta-analysis","volume":"18","author":"Sarhan","year":"2024","journal-title":"J. Robot. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.1002\/nau.25034","article-title":"The relationship between pre- and post-prostatectomy measures of pelvic floor muscle function and development of early incontinence after surgery","volume":"41","author":"Stafford","year":"2022","journal-title":"Neurourol. Urodyn."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Rahnama\u2019i, M.S., Marcelissen, T., Geavlete, B., Tutolo, M., and H\u00fcsch, T. (2021). Current management of post-radical prostatectomy urinary incontinence. Front. Surg., 8.","DOI":"10.3389\/fsurg.2021.647656"},{"key":"ref_28","first-page":"110","article-title":"Penile rehabilitation after radical prostatectomy: Does it work?","volume":"4","author":"Gandaglia","year":"2015","journal-title":"Transl. Androl. Urol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Gacci, M., De Nunzio, C., Sakalis, V., Rieken, M., Cornu, J.-N., and Gravas, S. (2023). Post-prostatectomy urinary incontinence. J. Clin. Med., 12.","DOI":"10.3390\/jcm12031190"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"144","DOI":"10.26444\/monz\/111668","article-title":"Physiotherapy treatment of urinary incontinence in men following radical prostatectomy","volume":"25","author":"Jurys","year":"2019","journal-title":"Med. Og. Nauk. Zdr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"30","DOI":"10.5114\/areh.2024.141355","article-title":"Physiotherapeutic evaluation of pelvic floor muscle function in patients after radical prostatectomy using ultrasound imaging: Retrospective study","volume":"38","author":"Jurys","year":"2024","journal-title":"Adv. Rehabil."},{"key":"ref_32","first-page":"543","article-title":"Diagnosis of urinary incontinence","volume":"87","author":"Khandelwal","year":"2013","journal-title":"Am. Fam. Physician."},{"key":"ref_33","first-page":"8664","article-title":"Standing cough test for evaluation of post-prostatectomy incontinence: A pilot study","volume":"24","author":"Morey","year":"2017","journal-title":"Can. J. Urol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"18472","DOI":"10.1038\/s41598-020-75567-8","article-title":"Pad test reliability","volume":"10","author":"Wu","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1308\/003588414X13946184903847","article-title":"Patient-reported outcome measures in male incontinence surgery","volume":"96","author":"Tran","year":"2014","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2617","DOI":"10.1007\/s00345-022-04146-5","article-title":"A systematic review of treatment options for post-prostatectomy incontinence","volume":"40","author":"Canning","year":"2022","journal-title":"World J. Urol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"658","DOI":"10.56434\/j.arch.esp.urol.20247706.90","article-title":"Pelvic floor muscle exercises can effectively improve urinary incontinence after radical prostatectomy: Systematic review and meta-analysis","volume":"77","author":"Zeng","year":"2024","journal-title":"Arch. Esp. Urol."},{"key":"ref_38","first-page":"CD014799","article-title":"Conservative interventions for urinary incontinence","volume":"4","author":"Johnson","year":"2023","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.eururo.2016.06.023","article-title":"Preoperative membranous urethral length measurement and continence recovery following radical prostatectomy: A systematic review and meta-analysis","volume":"71","author":"Mungovan","year":"2017","journal-title":"Eur. Urol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1997","DOI":"10.2147\/CIA.S228222","article-title":"The impact of pelvic floor muscle training on urinary incontinence in men after radical prostatectomy: A systematic review","volume":"14","author":"Strojek","year":"2019","journal-title":"Clin. Interv. Aging"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1055\/s-0040-1714287","article-title":"Biofeedback for pelvic floor disorders","volume":"34","author":"Hite","year":"2021","journal-title":"Clin. Colon Rectal Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1159\/000543133","article-title":"Effect of pelvic floor muscle training combined with electrical stimulation therapy on stress urinary incontinence: A meta-analysis","volume":"109","author":"Li","year":"2025","journal-title":"Urol. Int."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Mazur-Bialy, A., Tim, S., Ko\u0142oma\u0144ska-Bogucka, D., Burzy\u0144ski, B., Jurys, T., and P\u0142awiak, N. (2023). Physiotherapy as an effective method to support the treatment of male urinary incontinence: A systematic review. J. Clin. Med., 12.","DOI":"10.3390\/jcm12072536"},{"key":"ref_44","unstructured":"European Association of Urology (2026). EAU Guidelines. Edn. Presented at the EAU Annual Congress London, European Association of Urology."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1038\/s41585-021-00445-5","article-title":"Preoperative exercise interventions to optimize continence outcomes following radical prostatectomy","volume":"18","author":"Mungovan","year":"2021","journal-title":"Nat. Rev. Urol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Alouini, S., Memic, S., and Couillandre, A. (2022). Pelvic floor muscle training with biofeedback or electrostimulation. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19052789"},{"key":"ref_47","first-page":"CD001843","article-title":"Conservative management for post-prostatectomy urinary incontinence","volume":"1","author":"Anderson","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1111\/j.1442-2042.2012.02976.x","article-title":"Neurophysiology of stress urinary incontinence","volume":"19","author":"Yoshimura","year":"2012","journal-title":"Int. J. Urol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7245\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:25:43Z","timestamp":1790076343000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7245"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":48,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15187245"],"URL":"https:\/\/doi.org\/10.3390\/jcm15187245","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]}}}