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Preoperative pelvic floor physiotherapy improves continence after radical retropubic prostatectomy.
Int J Urol. 2013 Oct; 20(10):986-92.IJ

Abstract

OBJECTIVES

Urinary incontinence is a predictable sequela of radical retropubic prostatectomy, and is most severe in the early postoperative phase. The present study aimed to evaluate the effect of a physiotherapist-guided pelvic floor muscle training program, commenced preoperatively, on the severity and duration of urinary continence after radical retropubic prostatectomy.

METHODS

A retrospective analysis of men undergoing radical retropubic prostatectomy by one high-volume surgeon (n = 284) was carried out. The intervention group received physiotherapist-guided pelvic floor muscle training from 4 weeks preoperatively (n = 152), whereas the control group was provided with verbal instruction on pelvic floor muscle exercise by the surgeon alone (n = 132). Postoperatively, all patients received physiotherapist-guided pelvic floor muscle training. The primary outcome measure was 24-h pad weight at 6 weeks and 3 months postoperatively. Secondary outcome measures were the percentage of patients experiencing severe urinary incontinence, and patient-reported time to one and zero pad usage daily.

RESULTS

At 6 weeks postoperatively, the 24-h pad weight was significantly lower (9 g vs 17 g, P < 0.001) for the intervention group, which also showed less severe urinary incontinence (24-h pad weight >50 g; 8/152 patients vs 33/132 patients, P < 0.01). There was no significant difference between groups in the 24-h pad weight at 3 months (P = 0.18). Patient-reported time to one and zero pad usage was significantly less for the intervention group (P < 0.05). Multivariate Cox regression showed that preoperative physiotherapist-guided pelvic floor muscle training reduced time to continence (1 pad usage daily) by 28% (P < 0.05).

CONCLUSIONS

A physiotherapist-guided pelvic floor muscle training program, commenced 4 weeks preoperatively, significantly reduces the duration and severity of early urinary incontinence after radical retropubic prostatectomy.

Authors+Show Affiliations

Urological Cancer Outcomes Center, Discipline of Surgery, The University of Sydney.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23432098

Citation

Patel, Manish I., et al. "Preoperative Pelvic Floor Physiotherapy Improves Continence After Radical Retropubic Prostatectomy." International Journal of Urology : Official Journal of the Japanese Urological Association, vol. 20, no. 10, 2013, pp. 986-92.
Patel MI, Yao J, Hirschhorn AD, et al. Preoperative pelvic floor physiotherapy improves continence after radical retropubic prostatectomy. Int J Urol. 2013;20(10):986-92.
Patel, M. I., Yao, J., Hirschhorn, A. D., & Mungovan, S. F. (2013). Preoperative pelvic floor physiotherapy improves continence after radical retropubic prostatectomy. International Journal of Urology : Official Journal of the Japanese Urological Association, 20(10), 986-92. https://doi.org/10.1111/iju.12099
Patel MI, et al. Preoperative Pelvic Floor Physiotherapy Improves Continence After Radical Retropubic Prostatectomy. Int J Urol. 2013;20(10):986-92. PubMed PMID: 23432098.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preoperative pelvic floor physiotherapy improves continence after radical retropubic prostatectomy. AU - Patel,Manish I, AU - Yao,Jinna, AU - Hirschhorn,Andrew D, AU - Mungovan,Sean F, Y1 - 2013/02/21/ PY - 2012/09/23/received PY - 2013/01/06/accepted PY - 2013/2/26/entrez PY - 2013/2/26/pubmed PY - 2014/5/28/medline KW - incontinence KW - pelvic floor KW - physiotherapy KW - preoperative KW - radical prostatectomy SP - 986 EP - 92 JF - International journal of urology : official journal of the Japanese Urological Association JO - Int J Urol VL - 20 IS - 10 N2 - OBJECTIVES: Urinary incontinence is a predictable sequela of radical retropubic prostatectomy, and is most severe in the early postoperative phase. The present study aimed to evaluate the effect of a physiotherapist-guided pelvic floor muscle training program, commenced preoperatively, on the severity and duration of urinary continence after radical retropubic prostatectomy. METHODS: A retrospective analysis of men undergoing radical retropubic prostatectomy by one high-volume surgeon (n = 284) was carried out. The intervention group received physiotherapist-guided pelvic floor muscle training from 4 weeks preoperatively (n = 152), whereas the control group was provided with verbal instruction on pelvic floor muscle exercise by the surgeon alone (n = 132). Postoperatively, all patients received physiotherapist-guided pelvic floor muscle training. The primary outcome measure was 24-h pad weight at 6 weeks and 3 months postoperatively. Secondary outcome measures were the percentage of patients experiencing severe urinary incontinence, and patient-reported time to one and zero pad usage daily. RESULTS: At 6 weeks postoperatively, the 24-h pad weight was significantly lower (9 g vs 17 g, P < 0.001) for the intervention group, which also showed less severe urinary incontinence (24-h pad weight >50 g; 8/152 patients vs 33/132 patients, P < 0.01). There was no significant difference between groups in the 24-h pad weight at 3 months (P = 0.18). Patient-reported time to one and zero pad usage was significantly less for the intervention group (P < 0.05). Multivariate Cox regression showed that preoperative physiotherapist-guided pelvic floor muscle training reduced time to continence (1 pad usage daily) by 28% (P < 0.05). CONCLUSIONS: A physiotherapist-guided pelvic floor muscle training program, commenced 4 weeks preoperatively, significantly reduces the duration and severity of early urinary incontinence after radical retropubic prostatectomy. SN - 1442-2042 UR - https://www.unboundmedicine.com/medline/citation/23432098/Preoperative_pelvic_floor_physiotherapy_improves_continence_after_radical_retropubic_prostatectomy_ L2 - https://doi.org/10.1111/iju.12099 DB - PRIME DP - Unbound Medicine ER -