Both device-based and physiotherapist-guided pelvic floor muscle training combined with high-effort resistance training were associated with significant reductions in objectively measured urinary leakage after radical prostatectomy, with no statistically significant between-group differences observed.
All participants demonstrated a statistically significant reduction in 24-hour pad test values from baseline to the end of the 12-week program.
Treatment success (≥50% reduction in urinary leakage) did not differ significantly between the device-based PFMT group and the physiotherapist-guided PFMT group.
In a post hoc exploratory analysis restricted to participants achieving treatment success, the relative reduction in urinary leakage was greater in the device-based PFMT group than in the physiotherapist-guided PFMT group.
Time since surgery was a significant negative predictor of treatment success, while age and follow-up rehabilitation treatment were not.
Both intervention groups underwent a 12-week whole-body high-effort resistance training program performed at moderate to high loads in addition to their respective PFMT interventions.
This research suggests that men who experience urinary leakage after prostate removal surgery (radical prostatectomy) can benefit significantly from pelvic floor muscle training combined with high-intensity strength exercise. The study compared two approaches over 12 weeks: one using a non-invasive biofeedback device to guide pelvic floor exercises, and one using conventional physiotherapist-led pelvic floor training. Both groups also performed whole-body resistance (strength) training at moderate to high effort levels. About 88% of participants completed the program, and on average, all participants showed a meaningful reduction in urine leakage as measured by pad weight tests. The study found that roughly half of all participants (52.1%) achieved 'treatment success,' defined as at least a 50% reduction in urinary leakage, and this rate was similar between the two training approaches. In an exploratory analysis looking only at those who did achieve treatment success, the biofeedback device group showed a somewhat larger percentage reduction in leakage compared to the physiotherapist-guided group, but the authors caution that this finding should be interpreted carefully because it was not the primary analysis and was not statistically adjusted for multiple comparisons. Importantly, the sooner after surgery a man began the program, the more likely he was to achieve treatment success. This research suggests that both home device-based and clinician-guided pelvic floor training, when combined with structured strength training, may help reduce urinary leakage following prostate surgery. The finding that time since surgery matters highlights the potential importance of starting rehabilitation promptly after the operation. Neither patient age nor whether someone had received prior follow-up rehabilitation affected the likelihood of success.
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Upload Your LabsBabović M, Aguayo D, Wiskemann J. (2026). Non-invasive biofeedback-assisted vs. conventional pelvic floor muscle training combined with high-effort resistance training for urinary incontinence after radical prostatectomy: a randomized controlled trial.. BMC urology. https://doi.org/10.1186/s12894-026-02333-9