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Return to continence after radical retropubic prostatectomy: a randomized trial of verbal and written instructions versus therapist-directed pelvic floor muscle therapy.
Urology. 2008 Dec; 72(6):1280-6.U

Abstract

OBJECTIVES

To test the effectiveness of weekly postoperative pelvic floor muscle training (PFMT) versus supportive telephone contact by a urology nurse for men at 4 weeks after radical prostatectomy.

METHODS

This was a randomized controlled trial in three Canadian centers. At 4 weeks after surgery, standardized verbal and written instruction about PFMT was provided to all subjects. Randomization occurred after initial instruction. Continence was defined as 8 g or less of urine loss on a 24-hour pad test. Primary outcome was grams of urine loss on pad test; secondary outcomes were International Prostate Symptom Score (IPSS), Incontinence Impact Questionnaire (IIQ-7) score, cost, and perception of urine loss as a problem. Data were obtained at baseline (preoperatively) and at weeks 4, 8, 12, 16, and 28 and 1 year after surgery.

RESULTS

A total of 216 men were enrolled; 11 were dry or withdrew at 4 weeks. Ninety-nine were randomized to the control group and 106 to the treatment group. There were no group differences at baseline for prostate-specific antigen level (mean [standard deviation] 8.4 [10.4] ng/mL; 7.6 [4.6] ng/mL), Gleason score (6.3 [0.86]), IPSS, IIQ-7 score, pad test, or voiding diary. At 8 weeks 23% of the control group and 20% of the treatment group were continent; at 12 weeks, 28% and 32%; 16 weeks, 40% and 44%; 28 weeks, 50% and 47%; and at 52 weeks, 64% and 60%, respectively. There were no significant differences between groups at any time point for the outcome variables.

CONCLUSIONS

Verbal instruction and written information with telephone support seemed to be as effective as intensive PFMT. Less-intense therapy may be more cost-effective.

Authors+Show Affiliations

Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. Katherine.moore@ualberta.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18384853

Citation

Moore, Katherine N., et al. "Return to Continence After Radical Retropubic Prostatectomy: a Randomized Trial of Verbal and Written Instructions Versus Therapist-directed Pelvic Floor Muscle Therapy." Urology, vol. 72, no. 6, 2008, pp. 1280-6.
Moore KN, Valiquette L, Chetner MP, et al. Return to continence after radical retropubic prostatectomy: a randomized trial of verbal and written instructions versus therapist-directed pelvic floor muscle therapy. Urology. 2008;72(6):1280-6.
Moore, K. N., Valiquette, L., Chetner, M. P., Byrniak, S., & Herbison, G. P. (2008). Return to continence after radical retropubic prostatectomy: a randomized trial of verbal and written instructions versus therapist-directed pelvic floor muscle therapy. Urology, 72(6), 1280-6. https://doi.org/10.1016/j.urology.2007.12.034
Moore KN, et al. Return to Continence After Radical Retropubic Prostatectomy: a Randomized Trial of Verbal and Written Instructions Versus Therapist-directed Pelvic Floor Muscle Therapy. Urology. 2008;72(6):1280-6. PubMed PMID: 18384853.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Return to continence after radical retropubic prostatectomy: a randomized trial of verbal and written instructions versus therapist-directed pelvic floor muscle therapy. AU - Moore,Katherine N, AU - Valiquette,Luc, AU - Chetner,Michael P, AU - Byrniak,Stephen, AU - Herbison,G Peter, Y1 - 2008/04/02/ PY - 2007/08/16/received PY - 2007/11/24/revised PY - 2007/12/05/accepted PY - 2008/4/4/pubmed PY - 2009/1/7/medline PY - 2008/4/4/entrez SP - 1280 EP - 6 JF - Urology JO - Urology VL - 72 IS - 6 N2 - OBJECTIVES: To test the effectiveness of weekly postoperative pelvic floor muscle training (PFMT) versus supportive telephone contact by a urology nurse for men at 4 weeks after radical prostatectomy. METHODS: This was a randomized controlled trial in three Canadian centers. At 4 weeks after surgery, standardized verbal and written instruction about PFMT was provided to all subjects. Randomization occurred after initial instruction. Continence was defined as 8 g or less of urine loss on a 24-hour pad test. Primary outcome was grams of urine loss on pad test; secondary outcomes were International Prostate Symptom Score (IPSS), Incontinence Impact Questionnaire (IIQ-7) score, cost, and perception of urine loss as a problem. Data were obtained at baseline (preoperatively) and at weeks 4, 8, 12, 16, and 28 and 1 year after surgery. RESULTS: A total of 216 men were enrolled; 11 were dry or withdrew at 4 weeks. Ninety-nine were randomized to the control group and 106 to the treatment group. There were no group differences at baseline for prostate-specific antigen level (mean [standard deviation] 8.4 [10.4] ng/mL; 7.6 [4.6] ng/mL), Gleason score (6.3 [0.86]), IPSS, IIQ-7 score, pad test, or voiding diary. At 8 weeks 23% of the control group and 20% of the treatment group were continent; at 12 weeks, 28% and 32%; 16 weeks, 40% and 44%; 28 weeks, 50% and 47%; and at 52 weeks, 64% and 60%, respectively. There were no significant differences between groups at any time point for the outcome variables. CONCLUSIONS: Verbal instruction and written information with telephone support seemed to be as effective as intensive PFMT. Less-intense therapy may be more cost-effective. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/18384853/Return_to_continence_after_radical_retropubic_prostatectomy:_a_randomized_trial_of_verbal_and_written_instructions_versus_therapist_directed_pelvic_floor_muscle_therapy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(07)02605-2 DB - PRIME DP - Unbound Medicine ER -