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Randomized Controlled Trial
. 2024 Sep;134(3):398-406.
doi: 10.1111/bju.16369. Epub 2024 Apr 24.

Physiotherapy for continence and muscle function in prostatectomy: a randomised controlled trial

Mifuka Ouchi  1 , Takeya Kitta  2 , Hiroki Chiba  3 , Madoka Higuchi  3 , Yui Abe-Takahashi  1 , Mio Togo  1 , Naohisa Kusakabe  1 , Sachiyo Murai  1 , Hiroshi Kikuchi  3 , Ryuji Matsumoto  1 , Takahiro Osawa  3 , Takashige Abe  1 , Nobuo Shinohara  1
Affiliations
Randomized Controlled Trial

Physiotherapy for continence and muscle function in prostatectomy: a randomised controlled trial

Mifuka Ouchi et al. BJU Int. 2024 Sep.

Abstract

Objective: To assess the effectiveness of pre- and postoperative supervised pelvic floor muscle training (PFMT) on the recovery of continence and pelvic floor muscle (PFM) function after robot-assisted laparoscopic radical prostatectomy (RARP).

Patients and methods: We carried out a single-blind randomised controlled trial involving 54 male patients scheduled to undergo RARP. The intervention group started supervised PFMT 2 months before RARP and continued for 12 months after surgery with a physiotherapist. The control group was given verbal instructions, a brochure about PFMT, and lifestyle advice. The primary outcome was 24-h pad weight (g) at 3 months after RARP. The secondary outcomes were continence status (assessed by pad use), PFM function, and the Expanded Prostate Cancer Index Composite (EPIC) score.

Results: Patients who participated in supervised PFMT showed significantly improved postoperative urinary incontinence (UI) compared with the control group (5.0 [0.0-908.0] g vs 21.0 [0.0-750.0] g; effect size: 0.34, P = 0.022) at 3 months after RARP based on 24-h pad weight. A significant improvement was seen in the intervention compared with the control group (65.2% continence [no pad use] vs 31.6% continence, respectively) at 12 months after surgery (effect size: 0.34, P = 0.030). Peak pressure during a maximum voluntary contraction was higher in the intervention group immediately after catheter removal and at 6 months, and a longer duration of sustained contraction was found in the intervention group compared with the control group. We were unable to demonstrate a difference between groups in EPIC scores.

Conclusion: Supervised PFMT can improve postoperative UI and PFM function after RARP. Further studies are needed to confirm whether intra-anal pressure reflects PFM function and affects continence status in UI in men who have undergone RARP.

Keywords: continence; intra‐anal manometry; pelvic floor muscle function; pelvic floor muscle training; physiotherapy; randomised controlled trial; robot‐assisted laparoscopic radical prostatectomy; urinary incontinence.

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References

    1. Abrams P, Andersson KE, Apostolidis A et al. Evaluation and treatment of urinary incontinence, pelvic organ prolapse and faecal incontinence. In Abrams P, Cardozo L, Wagg A, Wein A eds, Incontinence, 6th edn. Bristol: ICI‐ICS, International Continence Society, 2017: 2549–2619
    1. Chang JI, Lam V, Patel MI. Preoperative pelvic floor muscle exercise and postprostatectomy incontinence: a systematic review and meta‐analysis. Eur Urol 2016; 69: 460–467
    1. Hirakawa T, Suzuki S, Kato K, Gotoh M, Yoshikawa Y. Randomized controlled trial of pelvic floor muscle training with or without biofeedback for urinary incontinence. Int Urogynecol J 2013; 24: 1347–1354
    1. Celiker Tosun O, Kaya Mutlu E, Ergenoglu AM et al. Does pelvic floor muscle training abolish symptoms of urinary incontinence? A randomized controlled trial. Clin Rehabil 2015; 29: 525–537
    1. Aksac B, Aki S, Karan A, Yalcin O, Isikoglu M, Eskiyurt N. Biofeedback and pelvic floor exercises for the rehabilitation of urinary stress incontinence. Gynecol Obstet Investig 2003; 56: 23–27

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