Urodynamic quantification of decrease in sphincter function after radical prostatectomy: Relation to postoperative continence status and the effect of intensive pelvic floor muscle exercises

2012 ◽  
Vol 31 (5) ◽  
pp. 646-651 ◽  
Author(s):  
Yvette D. Dubbelman ◽  
Jan Groen ◽  
Mark F. Wildhagen ◽  
Berend Rikken ◽  
J.L.H. Ruud Bosch
Keyword(s):  
Radical Prostatectomy ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Sphincter Function ◽  
Pelvic Floor Muscle Exercises ◽  
Postoperative Continence ◽  
Continence Status

scholarly journals Biofeedback-assisted pelvic floor muscle training in patients with urinary incontinence after laparoscopic and robot-assisted radical prostatectomy

2018 ◽  
Vol 14 (2) ◽  
pp. 102-108
Author(s):  
A. Z. Vinarov ◽  
L. M. Rapoport ◽  
G. E. Krupinov ◽  
Yu. L. Demidko ◽  
D. G. Tsarichenko ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Radical Prostatectomy ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle Training ◽  
Pelvic Floor Muscle ◽  
Muscle Contractions ◽  
Muscle Training ◽  
Robot Assisted ◽  
Pelvic Floor Muscle Exercises ◽  
Significant Difference

Background. Pelvic floor muscle exercises are used as a first-line treatment for urinary incontinence after radical prostatectomy. Their efficacy is still being investigated. The use of biofeedback when teaching pelvic floor muscle exercises to patients increases the effectiveness of therapy.Objective: to assess the efficacy of biofeedback-assisted pelvic floor muscle training in patients with urinary incontinence after laparoscopic and robot-assisted radical prostatectomy and to compare the results of teaching.Materials and methods. A total of 64 patients with urinary incontinence after nerve sparing prostatectomy underwent biofeedback-assisted pelvic floor muscle rehabilitation. Radical laparoscopic surgery was performed in 48 (75 %) patients, whereas robot-assisted surgery was performed in 16 (25 %) patients. The patients started their training 2 months postoperatively. We used two-channel electromyography with the Neurotrack ETS system (United Kingdom) to teach the patients isolated pelvic floor muscle contractions. After achieving a minimum activity of abdominal muscles during pelvic floor muscle contractions, the patients started exercises.Results. There was no significant difference in age between patients who underwent laparoscopic and robot-assisted radical prostatectomy (р = 0.79). Fifty-five patients (85.9%) acquired the skill of isolated pelvic floor muscle contractions and could perform training on their own. The remaining 9 patients (14.1 %) required regular support from healthcare professionals at an outpatient unit (1–2 biofeedback-assisted trainings per month). Thus, the type of surgery did not affect the process of training. The type of radical prostatectomy had no impact on the acquisition of the pelvic floor muscle contraction skill.Conclusion. The time for restoration of urinary continence by biofeedback-assisted pelvic floor muscle training did not vary between patients after laparoscopic and robot-assisted radical prostatectomy.

scholarly journals Does trunk muscle training with an oscillating rod improve urinary incontinence after radical prostatectomy? A prospective randomized controlled trial

2019 ◽  
Vol 34 (3) ◽  
pp. 320-333
Author(s):  
Marc Heydenreich ◽  
Christian Puta ◽  
Holger HW Gabriel ◽  
Andre Dietze ◽  
Peter Wright ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Radical Prostatectomy ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Pelvic Floor Muscle Exercises ◽  
Pad Test ◽  
Randomized Controlled

Objective: To investigate the effect of a new therapeutic approach, using an oscillating rod to strength the pelvic floor and deep abdominal musculature and to speed up recovery of continence after radical prostatectomy. Design: Prospective randomized controlled clinical trial. Setting: Inpatient uro-oncology rehabilitation clinic. Subjects: Ninety-three (intervention group (IG)) and ninety-one patients (control group (CG)) with urinary incontinence after prostatectomy were examined. Intervention: All patients were randomly allocated to either standard pelvic floor muscle exercises and oscillating rod therapy (IG) or standard pelvic floor muscle exercises and relaxation therapy (CG). Main outcome measures: Urinary incontinence (1- and 24-hour pad test) was assessed, and health-related quality of life (HRQL; Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire) was measured for all patients before and after three weeks of treatment. Results: One hundred and eighty-four patients (mean (SD) age: 64.1 (6.94) years) completed the study. The IG showed a significant reduction in urinary incontinence (1-hour pad test: P = 0.008, 24-hour pad test: P = 0.012) and a significant improvement of HRQL ( P = 0.017) compared with CG. Continence was significantly improved in both groups (1-hour pad test: 22.6–8.5 g (IG) vs. 23.0–18.1 g (CG)/24-hour pad test: 242.9–126.7 g (IG) vs. 237.6–180.9 g (CG)). Conclusion: The study demonstrated that a combination of conventional continence exercises and the new oscillation rod training increased abdominal and pelvic floor musculature and speeded up recovery of continence after radical prostatectomy.

scholarly journals The Effect of Pelvic Floor Muscle Training On Incontinence Problems After Radical Prostatectomy

2018 ◽  
Vol 12 (4) ◽  
pp. 1007-1015 ◽  
Author(s):  
Aylin Aydın Sayılan ◽  
Ayfer Özbaş
Keyword(s):  
Radical Prostatectomy ◽  
Pelvic Floor ◽  
Short Form ◽  
Pelvic Floor Muscle ◽  
Controlled Trial ◽  
Control Group ◽  
Objective Criterion ◽  
Pelvic Floor Muscle Exercises ◽  
Telephone Interviews ◽  
And Control

The aim of the current study was to determine the effect of pelvic floor muscle exercises (PFME/Kegel) training administered to patients scheduled for robot-assisted radical prostatectomy on postprocedural incontinence problems. This study was a randomized controlled trial. Pelvic floor muscle exercises were applied to the procedure group three times a day for 6 months. No exercises were applied to the control group. Incontinence and quality-of-life assessments of the 60 patients in the experimental and control groups were performed on months 0 (10 days after removal of the urinary catheter), 1, 3, and 6 through face-to-face and telephone interviews. Total Incontinence Consultation on Incontinence-Short Form scores, which provide an objective criterion for the evaluation of individuals with incontinence problems, decreased over time. This decrease was statistically highly significant in the third and sixth months. Pelvic muscle floor exercises are suitable for patients experiencing incontinence after radical prostatectomy.

scholarly journals Physiotherapy and Pelvic Floor Muscle Exercises for the Prevention and Treatment of Pregnancy-Related Pelvic Floor Dysfunctions: A Systematic Review and Meta-analysis

2019 ◽  
Vol 8 (2) ◽  
pp. 125-132
Author(s):  
Fahime Khorasani ◽  
Fariba Ghaderi ◽  
Parvin Sarbakhsh ◽  
Parisa Ahadi ◽  
Elahe Khorasani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Groups ◽  
Pelvic Floor Muscle Exercises ◽  
Significant Difference ◽  
Prevention And Treatment ◽  
Pfm Strength

Objectives: The present systematic review focused on the prevention or treatment of three main types of pelvic floor dysfunctions (PFDs) specifically pelvic organ prolapse (POP), urinary incontinence (UI), and fecal incontinence (FI) using physiotherapy and pelvic floor muscle exercises (PFMEs). With regard to the breadth of the problem, there is not much evidence grounded on the best management. The main purpose of this systematic review was to evaluate the effects of physiotherapy and PFMEs on the prevention and treatment of pregnancy-related PFDs; namely, POP, FI, and UI. Therefore, this review incorporated studies comparing the use of physiotherapy and PFMEs with every other existing interventions. Methods: This systematic review and meta-analysis was conducted on randomized-controlled-trial (RCT) articles and quasi-RCT designs through a search in the studies published with no time limits until December 2017 in the databases of PubMed (Medline), Web of Science, Scopus, Embase, Cochrane Library, and ProQuest. The meta-analysis was also applied for data synthesis. Moreover, heterogeneity was assessed using Cochran’s Q test and I2 index. Results: A total number of 26 RCTs were examined in this review in which the outcome variables were related to POP, UI, and FI prevalence; POP, UI, and FI severity, as well as pelvic floor muscle (PFM) strength and endurance. In most articles, UI prevalence or severity in intervention groups had significantly improved compared with those in controls. The number of studies examining POP and FI was also relatively low. In two studies, FI severity or prevalence in intervention groups had significantly enhanced in comparison with those in control groups; however, FI prevalence in two articles had been reported lower in intervention groups than that in control groups although no significant difference had been observed. There was also no significant improvement in intervention groups in two other studies in this respect. Besides, three articles had not reported traces of improvement in POP, as well as a significant difference between intervention and control groups. Nevertheless, two studies had found a significant improvement in POP in this regard. Based on meta-analysis results for the variable of PFM strength, Cochran’s Q test (P<0.001) and I2 index (90.02) indicated heterogeneity between studies; so, a random-effect meta-analysis was applied to estimate overall effect sizes. The overall mean differences following intervention between the study groups were also equal to 6.94, with a 95% CI (1.36 to 12.52). Conclusions: It was concluded that physiotherapy and PFMEs might have effects on pregnancy-related UI, but they had not consistently reduced FI severity or prevalence and failed to constantly improve POP.

scholarly journals Impact of supervised physiotherapeutic pelvic floor exercises for treating female stress urinary incontinence

2007 ◽  
Vol 125 (5) ◽  
pp. 265-269 ◽  
Author(s):  
Míriam Raquel Diniz Zanetti ◽  
Rodrigo de Aquino Castro ◽  
Adriana Lyvio Rotta ◽  
Patrícia Diniz dos Santos ◽  
Marair Sartori ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Subjective Evaluation ◽  
Female Stress Urinary Incontinence ◽  
Control Group ◽  
Pelvic Floor Muscle Exercises ◽  
Pad Test

CONTEXT AND OBJECTIVE: Urinary incontinence is a public health problem that affects more than 200 million people worldwide. Stress incontinence is the most prevalent type. Pelvic floor muscle exercises have been used for treating it, although there is no consensus regarding their application. The aim of this study was to compare the results from treating female stress urinary incontinence with pelvic floor muscle exercises with or without physiotherapist supervision. DESIGN AND SETTING: This was a randomized, prospective, controlled trial in the Urogynecology and Vaginal Surgery Sector, Universidade Federal de São Paulo. METHODS: Forty-four women were randomized to be treated for stress urinary incontinence with pelvic floor exercises for three consecutive months, into two groups: one with and the other without physiotherapist supervision. They were evaluated before and after treatment using a quality-of-life questionnaire, pad test, micturition diary and subjective evaluation. Descriptive analysis was used to evaluate the population. The homogeneity of the two groups was evaluated using the Kruskal-Wallis and Chi-squared tests. The success of the two groups after treatment was evaluated using the Wilcoxon test. RESULTS: The supervised group showed statistically greater improvement in the pad test, micturition diary and quality of life than did the control group. In the subjective evaluation, only 23.8% of the control group patients were satised with their treatment. In the supervised group, 66.8% of patients did not want any other treatment. CONCLUSION: Supervised pelvic floor muscle exercises presented better results in objective and subjective evaluations than did unsupervised exercises.

scholarly journals Pelvic floor muscle training in radical prostatectomy: a randomized controlled trial of the impacts on pelvic floor muscle function and urinary incontinence

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Joanne E. Milios ◽  
Timothy R. Ackland ◽  
Daniel J. Green
Keyword(s):  
Radical Prostatectomy ◽  
Pelvic Floor ◽  
Muscle Function ◽  
Pelvic Floor Muscle Training ◽  
Pelvic Floor Muscle ◽  
Intervention Group ◽  
Control Group ◽  
Muscle Fibres ◽  
Muscle Training ◽  
Pelvic Floor Muscle Function

Abstract Background Pelvic floor muscle training (PFM) training for post-prostatectomy incontinence (PPI) is an important rehabilitative approach, but the evidence base is still evolving. We developed a novel PFM training program focussed on activating fast and slow twitch muscle fibres. We hypothesized that this training, which commenced pre-operatively, would improve PFM function and reduce PPI, when compared to a control group. Methods This randomized trial allocated 97 men (63 ± 7y, BMI = 25.4, Gleason 7) undergoing radical prostatectomy (RP) to either a control group (n = 47) performing low-volume rehabilitation, or an intervention group (n = 50). Both interventions commenced 5 weeks prior to surgery and continued for 12 weeks post-RP. Participants were assessed pre-operatively and at 2, 6 and 12 weeks post-RP using 24 h pad weights, International Prostate Symptom Score (IPSS), Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) and real time ultrasound (RTUS) measurements of PFM function. Results Following RP, participants in the control group demonstrated a slower return to continence and experienced significantly more leakage (p < 0.05), measured by 24 h pad weight, compared to the intervention group, suggesting an impact of the prehabilitation protocol. PFM function measures were enhanced following RP in the intervention group. Secondary measures (IPSS, EPIC-CP and RTUS PFM function tests) demonstrated improvement across all time points, with the intervention group displaying consistently lower “bothersome” scores. Conclusions A pelvic floor muscle exercise program commenced prior to prostate surgery enhanced post-surgical measures of pelvic floor muscle function, reduced PPI and improved QoL outcomes related to incontinence. Trial registration The trial was registered in the Australia New Zealand Clinical Trials Registry and allocated as ACTRN12617001400358. The trial was registered on 4/10/2017 and this was a retrospective registration.

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