Pelvic Floor Muscle Training and Biofeedback for Urinary, Bowel, and Erectile Dysfunction

Post-prostatectomy incontinence (PPI) reduces postoperative quality of life by causing urinary incontinence, fecal incontinence, and erectile dysfunction. Pelvic floor muscle training (PFMT) is considered the first-line conservative treatment for urinary incontinence (UI), as suggested by the International Continence Society (ICS). Standardized treatment protocols are lacking, both regarding preoperative and postoperative PFMT and its benefits. The rehabilitation treatment of the pelvic floor involves the treatment of alterations that affect not only the pelvic floor but also elements of the urological, defecation, genitosexual, postural, and pelvic static systems. It is possible that PFMT can improve fecal incontinence, as well as urinary incontinence, but there are no specific protocols. In case of erectile dysfunction, PFMT could increase strength, resistance, and muscular coordination of the ischiocavernosus and bulbocavernous, but there is limited evidence of its effectiveness. There is strong evidence that, in addition to PFMT, biofeedback can provide medium- and long-term benefits to men suffering from urinary incontinence after a prostatectomy, is effective in achieving remission of fecal incontinence, and can help with erectile dysfunction.