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The role of pelvic floor exercises on post-prostatectomy incontinence.
J Urol. 2003 Jul; 170(1):130-3.JU

Abstract

PURPOSE

Post-radical prostatectomy incontinence occurs in 0.5% to 87% of patients. This condition may be attributable to intrinsic sphincteric deficiency, and/or detrusor abnormalities. Previous studies of pelvic floor exercise (PFE) for improving post-prostatectomy incontinence have shown mixed results. We determined whether preoperative and early postoperative biofeedback enhanced PFE with a dedicated physical therapist would improve the early return of urinary incontinence.

MATERIALS AND METHODS

A total of 38 consecutive patients undergoing radical prostatectomy from November 1998 to June 1999 were randomly assigned to a control or a treatment group. The treatment group of 19 patients was referred to physical therapy and underwent PFE sessions before and after surgery. Patients were also given instructions to continue PFE at home twice daily after surgery. The control group of 19 men underwent surgery without formal PFE instructions. All patients completed postoperative urinary incontinence questionnaires at 6, 12, 16, 20, 28 and 52 weeks. Incontinence was measured by the number of pads used with 0 or 1 daily defined as continence.

RESULTS

Overall 66% of the patients were continent at 16 weeks. A greater fraction of the treatment group regained urinary continence earlier compared with the control group at 12 weeks (p <0.05). Three control and 2 treatment group patients had severe incontinence (greater than 3 pads daily) at 16 and 52 weeks. Of all patients 82% regained continence by 52 weeks.

CONCLUSIONS

PFE therapy instituted prior to radical prostatectomy aids in the earlier achievement of urinary incontinence. However, PFE has limited benefit in patients with severe urinary incontinence 16 weeks after surgery. There is a minimal long-term benefit of PFE training since continence rates at 1 year were similar in the 2 groups.

Authors+Show Affiliations

Department of Urology, Kaiser Permanente Medical Center, 4900 Sunset Boulevard, 2nd Floor, Los Angeles, CA 90027, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

12796664

Citation

Parekh, A R., et al. "The Role of Pelvic Floor Exercises On Post-prostatectomy Incontinence." The Journal of Urology, vol. 170, no. 1, 2003, pp. 130-3.
Parekh AR, Feng MI, Kirages D, et al. The role of pelvic floor exercises on post-prostatectomy incontinence. J Urol. 2003;170(1):130-3.
Parekh, A. R., Feng, M. I., Kirages, D., Bremner, H., Kaswick, J., & Aboseif, S. (2003). The role of pelvic floor exercises on post-prostatectomy incontinence. The Journal of Urology, 170(1), 130-3.
Parekh AR, et al. The Role of Pelvic Floor Exercises On Post-prostatectomy Incontinence. J Urol. 2003;170(1):130-3. PubMed PMID: 12796664.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of pelvic floor exercises on post-prostatectomy incontinence. AU - Parekh,A R, AU - Feng,M I, AU - Kirages,D, AU - Bremner,H, AU - Kaswick,J, AU - Aboseif,S, PY - 2003/6/11/pubmed PY - 2003/7/10/medline PY - 2003/6/11/entrez SP - 130 EP - 3 JF - The Journal of urology JO - J Urol VL - 170 IS - 1 N2 - PURPOSE: Post-radical prostatectomy incontinence occurs in 0.5% to 87% of patients. This condition may be attributable to intrinsic sphincteric deficiency, and/or detrusor abnormalities. Previous studies of pelvic floor exercise (PFE) for improving post-prostatectomy incontinence have shown mixed results. We determined whether preoperative and early postoperative biofeedback enhanced PFE with a dedicated physical therapist would improve the early return of urinary incontinence. MATERIALS AND METHODS: A total of 38 consecutive patients undergoing radical prostatectomy from November 1998 to June 1999 were randomly assigned to a control or a treatment group. The treatment group of 19 patients was referred to physical therapy and underwent PFE sessions before and after surgery. Patients were also given instructions to continue PFE at home twice daily after surgery. The control group of 19 men underwent surgery without formal PFE instructions. All patients completed postoperative urinary incontinence questionnaires at 6, 12, 16, 20, 28 and 52 weeks. Incontinence was measured by the number of pads used with 0 or 1 daily defined as continence. RESULTS: Overall 66% of the patients were continent at 16 weeks. A greater fraction of the treatment group regained urinary continence earlier compared with the control group at 12 weeks (p <0.05). Three control and 2 treatment group patients had severe incontinence (greater than 3 pads daily) at 16 and 52 weeks. Of all patients 82% regained continence by 52 weeks. CONCLUSIONS: PFE therapy instituted prior to radical prostatectomy aids in the earlier achievement of urinary incontinence. However, PFE has limited benefit in patients with severe urinary incontinence 16 weeks after surgery. There is a minimal long-term benefit of PFE training since continence rates at 1 year were similar in the 2 groups. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/12796664/The_role_of_pelvic_floor_exercises_on_post_prostatectomy_incontinence_ L2 - https://www.jurology.com/doi/10.1097/01.ju.0000072900.82131.6f?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -