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Influence of preoperative and postoperative pelvic floor muscle training (PFMT) compared with postoperative PFMT on urinary incontinence after radical prostatectomy: a randomized controlled trial.
Eur Urol. 2013 Nov; 64(5):766-72.EU

Abstract

BACKGROUND

The efficacy of preoperative pelvic floor muscle training (PFMT) for urinary incontinence (UI) after open radical prostatectomy (ORP) and robot-assisted laparoscopic radical prostatectomy (RARP) is still unclear.

OBJECTIVE

To determine whether patients with additional preoperative PFMT regain urinary continence earlier than patients with only postoperative PFMT after ORP and RARP.

DESIGN, SETTING, AND PARTICIPANTS

A randomized controlled trial enrolled 180 men who planned to undergo ORP/RARP.

INTERVENTION

The experimental group (E, n=91) started PFMT 3 wk before surgery and continued after surgery. The control group (C, n=89) started PFMT after catheter removal.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

The primary end point was time to continence. Patients measured urine loss daily (24-h pad test) until total continence (three consecutive days of 0 g of urine loss) was achieved. Secondary end points were 1-h pad test, visual analog scale (VAS), International Prostate Symptom Score (IPSS), and quality of life (King's Health Questionnaire [KHQ]). Kaplan-Meier analysis and Cox regression with correction for two strata (age and type of surgery) compared time and continence. The Fisher exact test was applied for the 1-h pad test and VAS; the Mann-Whitney U test was applied for IPSS and KHQ.

RESULTS AND LIMITATIONS

Patients with additional preoperative PFMT had no shorter duration of postoperative UI compared with patients with only postoperative PFMT (p=0.878). Median time to continence was 30 and 31 d, and median amount of first-day incontinence was 108 g and 124 g for groups E and C, respectively. Cox regression did not indicate a significant difference between groups E and C (p=0.773; hazard ratio: 1.047 [0.768-1.425]). The 1-h pad test, VAS, and IPSS were comparable between both groups. However, "incontinence impact" (KHQ) was in favor of group E at 3 mo and 6 mo after surgery.

CONCLUSIONS

Three preoperative sessions of PFMT did not improve postoperative duration of incontinence.

TRIAL REGISTRATION

Netherlands Trial Register No. NTR 1953.

Authors+Show Affiliations

KU Leuven, Department of Rehabilitation Science, Leuven, Belgium. Electronic address: inge.geraerts@faber.kuleuven.be.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

23357349

Citation

Geraerts, Inge, et al. "Influence of Preoperative and Postoperative Pelvic Floor Muscle Training (PFMT) Compared With Postoperative PFMT On Urinary Incontinence After Radical Prostatectomy: a Randomized Controlled Trial." European Urology, vol. 64, no. 5, 2013, pp. 766-72.
Geraerts I, Van Poppel H, Devoogdt N, et al. Influence of preoperative and postoperative pelvic floor muscle training (PFMT) compared with postoperative PFMT on urinary incontinence after radical prostatectomy: a randomized controlled trial. Eur Urol. 2013;64(5):766-72.
Geraerts, I., Van Poppel, H., Devoogdt, N., Joniau, S., Van Cleynenbreugel, B., De Groef, A., & Van Kampen, M. (2013). Influence of preoperative and postoperative pelvic floor muscle training (PFMT) compared with postoperative PFMT on urinary incontinence after radical prostatectomy: a randomized controlled trial. European Urology, 64(5), 766-72. https://doi.org/10.1016/j.eururo.2013.01.013
Geraerts I, et al. Influence of Preoperative and Postoperative Pelvic Floor Muscle Training (PFMT) Compared With Postoperative PFMT On Urinary Incontinence After Radical Prostatectomy: a Randomized Controlled Trial. Eur Urol. 2013;64(5):766-72. PubMed PMID: 23357349.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of preoperative and postoperative pelvic floor muscle training (PFMT) compared with postoperative PFMT on urinary incontinence after radical prostatectomy: a randomized controlled trial. AU - Geraerts,Inge, AU - Van Poppel,Hendrik, AU - Devoogdt,Nele, AU - Joniau,Steven, AU - Van Cleynenbreugel,Ben, AU - De Groef,An, AU - Van Kampen,Marijke, Y1 - 2013/01/21/ PY - 2012/11/14/received PY - 2013/01/14/accepted PY - 2013/1/30/entrez PY - 2013/1/30/pubmed PY - 2014/8/5/medline KW - Pelvic floor muscle training KW - Radical prostatectomy KW - Urinary incontinence SP - 766 EP - 72 JF - European urology JO - Eur Urol VL - 64 IS - 5 N2 - BACKGROUND: The efficacy of preoperative pelvic floor muscle training (PFMT) for urinary incontinence (UI) after open radical prostatectomy (ORP) and robot-assisted laparoscopic radical prostatectomy (RARP) is still unclear. OBJECTIVE: To determine whether patients with additional preoperative PFMT regain urinary continence earlier than patients with only postoperative PFMT after ORP and RARP. DESIGN, SETTING, AND PARTICIPANTS: A randomized controlled trial enrolled 180 men who planned to undergo ORP/RARP. INTERVENTION: The experimental group (E, n=91) started PFMT 3 wk before surgery and continued after surgery. The control group (C, n=89) started PFMT after catheter removal. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary end point was time to continence. Patients measured urine loss daily (24-h pad test) until total continence (three consecutive days of 0 g of urine loss) was achieved. Secondary end points were 1-h pad test, visual analog scale (VAS), International Prostate Symptom Score (IPSS), and quality of life (King's Health Questionnaire [KHQ]). Kaplan-Meier analysis and Cox regression with correction for two strata (age and type of surgery) compared time and continence. The Fisher exact test was applied for the 1-h pad test and VAS; the Mann-Whitney U test was applied for IPSS and KHQ. RESULTS AND LIMITATIONS: Patients with additional preoperative PFMT had no shorter duration of postoperative UI compared with patients with only postoperative PFMT (p=0.878). Median time to continence was 30 and 31 d, and median amount of first-day incontinence was 108 g and 124 g for groups E and C, respectively. Cox regression did not indicate a significant difference between groups E and C (p=0.773; hazard ratio: 1.047 [0.768-1.425]). The 1-h pad test, VAS, and IPSS were comparable between both groups. However, "incontinence impact" (KHQ) was in favor of group E at 3 mo and 6 mo after surgery. CONCLUSIONS: Three preoperative sessions of PFMT did not improve postoperative duration of incontinence. TRIAL REGISTRATION: Netherlands Trial Register No. NTR 1953. SN - 1873-7560 UR - https://www.unboundmedicine.com/medline/citation/23357349/Influence_of_preoperative_and_postoperative_pelvic_floor_muscle_training__PFMT__compared_with_postoperative_PFMT_on_urinary_incontinence_after_radical_prostatectomy:_a_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(13)00025-0 DB - PRIME DP - Unbound Medicine ER -