Postoperative urinary incontinence (PPI) is a common complication following radical prostatectomy (RP) and significantly impacts patients' quality of life. This study aims to evaluate the effect of perioperative electrophysiological therapy on early urinary control recovery following RP, particularly within the treatment windows of 1 week before and 2 weeks after surgery.

This prospective observational study included 30 patients undergoing RP, who were divided into two groups based on the intervention: the perioperative electrophysiological therapy group (n=15, receiving electrophysiological therapy 1 week before and 2 weeks after surgery) and the postoperative electrophysiological therapy group (n=15, receiving only postoperative therapy for 2 weeks). All patients received pelvic floor electromyographic therapy three times a week, with each session lasting 30 minutes, and the intensity of therapy was gradually adjusted according to patient tolerance. The primary endpoints were the incidence of urinary incontinence at 1-, 3-, and 6-months post-surgery, assessed using a 24-hour pad test and self-reported questionnaires. Secondary endpoints included patients’ quality of life and time to urinary control recovery.

At 1-month post-surgery, the urinary control recovery rate was 60.0% in the perioperative electrophysiological therapy group, compared to 56.0% in the postoperative therapy group, with no significant difference (p=0.075). However, at 3 months, the perioperative therapy group showed a significantly higher recovery rate (86.7% vs. 63.3%, p=0.041). At 6 months, the recovery rate was 93.3% vs. 73.3% (p=0.038). The time to urinary control recovery was shorter in the perioperative therapy group (median recovery time 8 weeks vs. 12 weeks, p=0.027). Additionally, the perioperative therapy group had significantly better quality of life scores at 6 months post-surgery, including the ICIQ-UI SF score (3.2 ± 1.1 vs. 5.8 ± 1.3, p=0.031) and EPIC-Urinary Domain score (88.5 ± 4.8 vs. 79.3 ± 5.2, p=0.035). No serious adverse events related to electrophysiological therapy were observed during the study.

Perioperative electrophysiological therapy accelerates urinary control recovery and significantly reduces the incidence of urinary incontinence at 3 and 6 months after RP, compared to postoperative therapy alone. This study suggests that early electrophysiological therapy, within the perioperative period, can be an important part of a comprehensive urinary control rehabilitation strategy after RP, with significant clinical value.