Penile vibratory stimulation in the treatment of post-prostatectomy incontinence: a randomized pilot study

Abstract

Aims: To examine penile vibratory stimulation (PVS) in the treatment of post-prostatectomy urinary incontinence (UI).

Methods: Patients with post-prostatectomy UI were included in a 12-week trial. A 24-hr pad test and a 72-hr voiding diary were collected at baseline. Participants were randomized to receive PVS for the first 6 weeks (group 1) or for the final 6 weeks (group 2) of the study. The primary outcome was the difference in leakage between groups 1 and 2 at 6 weeks as measured by changes in the pad test. The trial was registered at www.clinicaltrials.org (NCT01540656).

Results: Data from 31 men were available for analyses. The difference in the change on the pad test between the groups did not reach statistical significance at 6 weeks (P = 0.13) while the change in incontinence episodes between groups approached statistical significance (P = 0.052). However, there was a median reduction of -33 g (P = 0.021) on the pad test and a median reduction in daily incontinence episodes of -1 (P = 0.023) in group 1 at 6 weeks. At 12 weeks, group 2 had a median decrease on the pad test of -8 g (P = 0.10) and no change in incontinence episodes. A pooled analysis showed a decline on the pad test of -13.5 g (P = 0.004) after PVS. Small improvements were seen in subjective symptom scores and 58% stated to be satisfied with PVS. Self-limiting side effects were experienced by 15% of patients.

Conclusions: PVS is feasible in the treatment of post-prostatectomy UI. Larger trials are needed to document the clinical efficacy.

Keywords: conservative treatment; incontinence; nerve stimulation; penile vibratory stimulation; prostatic neoplasms; radical prostatectomy; urinary incontinence.