Influence of Preoperative and Postoperative Pelvic Floor Muscle Training (PFMT) Compared with Postoperative PFMT on Urinary Incontinence After Radical Prostatectomy: A Randomized Controlled Trial

Published on Nov 1, 2013in European Urology20.096
· DOI :10.1016/J.EURURO.2013.01.013
Inge Geraerts17
Estimated H-index: 17
(Katholieke Universiteit Leuven),
Hendrik Van Poppel83
Estimated H-index: 83
(Katholieke Universiteit Leuven)
+ 4 AuthorsMarijke Van Kampen18
Estimated H-index: 18
(Katholieke Universiteit Leuven)
Sources
Abstract
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 0g 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 108g and 124g 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.
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#2Matthias Trottmann (LMU: Ludwig Maximilian University of Munich)H-Index: 13
Last. Armin J. Becker (LMU: Ludwig Maximilian University of Munich)H-Index: 24
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Abstract Introduction Radical prostatectomy (RP) is curative for localized prostatic cancer. Incontinence after RP (P-RP-I) varies widely (2% to Methods Between January 2002 and December 2004, a total of 911 patients, median age 63years (46–78), with different grades of P-RP-I have been retrospectively examined for perioperative risk factors and effect of rehabilitation procedures. These consecutive patients were from 67 clinics with median postoperative interval of 26 days. Incontinence was gra...
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#1Michael Froehner (TUD: Dresden University of Technology)H-Index: 25
#2Manfred P. Wirth (TUD: Dresden University of Technology)H-Index: 67
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#1Daniele Tienforti (CUA: The Catholic University of America)H-Index: 5
#2Emilio Sacco (CUA: The Catholic University of America)H-Index: 20
Last. Pierfrancesco Bassi (CUA: The Catholic University of America)H-Index: 37
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Study Type – Therapy (RCT) Level of Evidence 1b What's known on the subject? and What does the study add? Peri-operative pelvic floor muscle training reduces urinary incontinence for men undergoing radical prostatectomy (RP). A preoperative biofeedback session, combined with postoperative pelvic floor muscle training, and assisted sessions on a monthly basis only, is an effective low-intensity programme to improve recovery of continence in patients undergoing RP. OBJECTIVE • To evaluate the effi...
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#9Vipul R. Patel (Florida Hospital Celebration Health)H-Index: 54
Abstract Context Robot-assisted radical prostatectomy (RARP) was proposed to improve functional outcomes in comparison with retropubic radical prostatectomy (RRP) or laparoscopic radical prostatectomy (LRP). In the initial RARP series, 12-mo urinary continence recovery rates ranged from 84% to 97%. However, the few available studies comparing RARP with RRP or LRP published before 2008 did not permit any definitive conclusions about the superiority of any one of these techniques in terms of urina...
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#1Seong Cheol Kim (Inje University)H-Index: 10
#2Cheryn Song (UOU: University of Ulsan)H-Index: 24
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Abstract Background Early studies reported comparative results of functional outcomes between robot-assisted (RARP) and retropubic radical prostatectomy (RRP). However, well-controlled single-surgeon prospective studies comparing the outcomes are rare. Objective To compare functional outcomes after RARP and RRP performed by a single surgeon, and to identify factors predictive of early return of continence and potency. Design, setting, and participants A total of 763 consecutive patients undergoi...
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#2Philipp BaumeisterH-Index: 7
Last. Agostino MatteiH-Index: 19
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Background: Robot-assisted radical prostatectomy (RALP) is performed worldwide, even in institutions with limited caseloads. However, although the results of large RALP series are available, oncologic and functional outcomes as well as complications from low-caseload centres are lacking. Objective: To compare perioperative, oncologic, and functional outcomes from two consecutive series of patients with localised prostate cancer treated by retropubic radical prostatectomy (RRP) or recently establ...
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#1Lucia S Ribeiro (USP: University of São Paulo)H-Index: 3
#2Cristina Prota (USP: University of São Paulo)H-Index: 4
Last. Miguel Srougi (USP: University of São Paulo)H-Index: 59
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Purpose: The impact of pelvic floor muscle training on the recovery of urinary continence after radical prostatectomy is still controversial. We tested the effectiveness of biofeedback-pelvic floor muscle training in improving urinary incontinence in the 12 months following radical prostatectomy.Materials and Methods: A total of 73 patients who underwent radical prostatectomy were randomized to a treatment group (36) receiving biofeedback-pelvic floor muscle training once a week for 3 months as ...
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#1A. CentemeroH-Index: 4
#2Lorenzo RigattiH-Index: 5
Last. Giorgio GuazzoniH-Index: 71
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Abstract Background Despite improvements in surgical techniques, urinary incontinence (UI) is not uncommon after radical prostatectomy (RP), and it may dramatically worsen quality of life (QoL). Objective To determine the benefit of starting pelvic floor muscle exercise (PFME) 30d before RP and of continuing PFME postoperatively for early recovery of continence. Design, setting, and participants A randomised, prospective study was designed. Men with localised prostate cancer (PCa) who underwent ...
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#1Debora Marchiori (UNIBO: University of Bologna)H-Index: 6
Last. Giuseppe MartoranaH-Index: 46
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Purpose: radical prostatectomy (RP) is affected by urinary incontinence (UI) that, even if temporary, can severely impact patients quality of life. We investigated if a post surgery tutored and personal trained pelvic floor re-educational program improves continence recovery more than pelvic floor exercises performed by patients on their own. Patients and Methods: 332 incontinent (>1 pad/daily) patients (pts) submitted to RP between 2006 and 2008 were prospectively randomized in group A (166 pts...
#1Bernardo RoccoH-Index: 34
#2Deliu Victor MateiH-Index: 20
Last. Ottavio De Cobelli (University of Milan)H-Index: 33
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OBJECTIVE To compare the early oncological, perioperative and functional outcomes of robotic-assisted radical prostatectomy (RARP) vs open retropubic RP (RRP) in a laparoscopically naive centre, as robotic assistance aids the laparoscopically naive surgeon in minimally invasive prostate surgery, by offering magnification and superior dexterity. PATIENTS AND METHODS From 1 November 2006 to 31 December 2007, 120 patients had RARP; this group was followed prospectively and evaluated for early oncol...
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#1Freerk T. Baumann (University of Cologne)H-Index: 1
#2Nadine Reimer (University of Cologne)
Last. Robert U. Newton (ECU: Edith Cowan University)H-Index: 128
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Background null Urinary incontinence is one of the most clinically relevant side effects in the treatment of prostate cancer patients. The aim of this systematic review and meta-analysis was to analyze the specific exercise effects of supervised versus unsupervised pelvic floor muscle exercise (PFME) and exercise volume on urinary incontinence status after radical prostatectomy. null Methods null A systematic data search was performed for studies published from January 2000 to December 2020 usin...
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#1Tiankuo Kou (Capital Medical University)H-Index: 1
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Digestive system tumors, which mainly include esophagus, stomach, colorectum, liver, pancreas, bile duct, and some other tumors, often have a poor prognosis. N6-methyladenosine (m6A) has critical functions in development and tumorigenesis and may help improve the molecular mechanisms of digestive system tumors. However, current understanding of the reconstitution of m6A in digestive system tumors is far from comprehensive. Herein, this study systematically analyzed multi-layered genomic characte...
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#1Ervandy Rangganata (UI: University of Indonesia)H-Index: 1
#2Harrina Erlianti Rahardjo (UI: University of Indonesia)H-Index: 4
PURPOSE To evaluate whether additional PFMT, which began before radical prostatectomy and resumes immediately after catheter removal, will significantly improve urinary incontinence after RP. MATERIALS AND METHODS We reviewed articles obtained from MEDLINE, CENTRAL, EBSCOHost, CINAHL, and Elsevier from July - August 2020, which compared preoperative PFMT with postoperative PMFT or non-PFMT, with continence incidence parameters. There were no restrictions on the definition of incontinence, treatm...
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#1Sean F. MungovanH-Index: 6
#2Sigrid Carlsson (University of Gothenburg)H-Index: 23
Last. Manish I. Patel (USYD: University of Sydney)H-Index: 27
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Urinary incontinence is a common and predictable consequence among men with localized prostate cancer who have undergone radical prostatectomy. Despite advances in the surgical technique, urinary continence recovery time remains variable. A range of surgical and patient-related risk factors contributing to urinary incontinence after radical prostatectomy have been described, including age, BMI, membranous urethral length and urethral sphincter insufficiency. Physical activity interventions incor...
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#1Yoshihisa Matsukawa (Nagoya University)H-Index: 20
#2Yasushi Yoshino (Nagoya University)H-Index: 15
Last. Momokazu Gotoh (Nagoya University)H-Index: 44
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PURPOSE Some patients who undergo robot-assisted laparoscopic radical prostatectomy (RARP) continue to experience long-term urinary incontinence (UI). This study aimed to evaluate easily obtainable factors that can predict long-term UI following RARP. MATERIALS AND METHODS A total of 315 patients who underwent RARP for localised prostatic cancer were analysed. We separated the patients into two groups, namely, the Continence group and the Incontinence group, according to the presence or absence ...
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#1Irmina Nahon (UC: University of Canberra)H-Index: 3
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#1Arjun Nathan (University of Cambridge)H-Index: 1
#2Shivani Shukla (University of Cambridge)H-Index: 1
Last. Benjamin W LambH-Index: 2
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To assess whether the timing of post-operative Phosphodiesterase Inhibitor (PDE5i) therapy after Robot-Assisted Radical Prostatectomy (RARP) is associated with a change in early erectile function (EF) outcomes, continence or safety outcomes. Data were prospectively collected from a single surgeon in one tertiary centre. 158 patients were treated with PDE5i therapy post RARP over a 2-year period. PDE5i therapy was started: immediately (day 1-2) post-op in 29%, early (day 3-14) post-op in 37% and ...
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#1Yeong Uk Kim (Yeungnam University)H-Index: 1
#2Dong Gyu Lee (Yeungnam University)H-Index: 12
Last. Young Hwii Ko (Yeungnam University)H-Index: 3
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Background To determine the benefit of pelvic floor muscle exercise with visual biofeedback on promoting patient recovery from incontinence, we investigated variables associated with the early restoration of continence for patients who underwent robot-assisted radical prostatectomy. Methods Of the 83 patients enrolled, 41 consecutive patients completed pelvic floor muscle exercise (the exercise group), and the other 42 consecutive patients just before the pelvic floor muscle exercise program com...
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Pelvic organ prolapse and urinary incontinence affect approximately 6-11% and 6-40% of women, respectively. These pathologies could result from a weakness of pelvic floor muscles (PFM) caused by previous deliveries, aging or surgery. It seems reasonable that improving PFM efficacy should positively impact both pelvic floor therapy and surgical outcomes. Nonetheless, the existing data are inconclusive and do not clearly support the positive impact of preoperative pelvic floor muscle training on t...
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