Is pilates as effective as conventional pelvic floor muscle exercises in the conservative treatment of post-prostatectomy urinary incontinence? A randomised controlled trial

Abstract

Aims: To verify the efficacy of a Pilates exercise program compared to conventional pelvic floor muscle exercise (PFME) protocol in the conservative treatment of post-prostatectomy urinary incontinence (PPUI).

Methods: Baseline assessment was performed four weeks postoperatively and included 24 hr pad test, bladder diary, and the ICIQ-SF. Patients were randomised into three groups: Pilates (G1), PFME combined with anal electrical stimulation (G2), and a control group (G3). Both treatment groups had to perform 10 weekly treatment sessions. Primary outcomes were mean reduction of daily pads and mean reduction of ICIQ-SF score four months after surgery. The significance level was set at P < 0.05.

Results: 85 patients completed the study. Differences between treatment groups (G1 and G2) in terms of mean reduction in daily pad usage, 24 hr pad test, and ICIQ-SF scores were not statistically significant (P > 0.05). The control group differed from G1 in daily pad usage (P = 0.01) and ICIQ-SF score (P = 0.0073). Intergroup comparisons revealed that 57.7% of the volunteers in G1 and 50% of the individuals from G2 no longer used pads by the end of the treatment period (P = 0.57). In the control group, 22.6% were not using pads four months after surgery, with statistical difference compared to G1 (P < 0.05).

Conclusions: The Pilates exercise program proved to be as effective as conventional PFME to speed up continence recovery in PPUI. It also achieved a higher rate of fully continent patients when compared to the control group in the short-term. Neurourol. Urodynam. 35:615-621, 2016. © 2015 Wiley Periodicals, Inc.

Keywords: clinical trial; male; pelvic floor; physiotherapy; urinary incontinence.