Biofeedback vs verbal feedback as learning tools for pelvic muscle exercises in the early management of urinary incontinence after radical prostatectomy.
OBJECTIVE
To evaluate the comparative effectiveness of electromyographic (EMG) biofeedback with verbal instructions as learning tools of pelvic muscle exercises (PMEs) in the early management of urinary incontinence after radical prostatectomy.


METHODS
Forty-two consecutive patients (mean age 64 years, sd 4.2), with urinary incontinence after radical retropubic prostatectomy for localized prostate cancer, were randomized to receive biofeedback (group A, 28 men) or verbal feedback (group B, 14 men) as learning tools for PMEs immediately after catheter removal. Group A received 15 sessions of EMG biofeedback (three times weekly, 30 min each) and group B verbal instructions. Evaluation at baseline and 1, 2, 3 and 6 months included the 1-h pad-test and a questionnaire (number of pads/day and incontinence episodes).


RESULTS
By the last follow-up, 27 patients had received biofeedback and 15 verbal instructions. Data were analysed according to the intention-to-treat principle. Urine loss as assessed by the 1-h pad-test at baseline, 1, 2, 3 and 6 months was 39, 18, 7, 4 and 3 g for group A and 31, 11, 3, 1 and 0 g for group B, respectively (P > 0.05). The number of pads/day was 3.9, 3.4, 1.2, 0.8 and 0.4 for group A and 3.6, 1.8, 0.9, 0.4 and 0.2 for group B, respectively (P > 0.05). The overall continence rate at 6 months was objectively (urine loss > 1 g) 91% and subjectively (0-1 pad/day) 95%.


CONCLUSIONS
Intensive verbal instructions and biofeedback were both very effective behavioural methods and learning tools for PMEs in the early management of urinary incontinence after radical prostatectomy.
Floratos
D L
DL
Department of Urology, Polykliniki Hospital, 27 G. Papandreou str., Zografou 157.73, Athens, Greece. flordial@yahoo.com
Sonke
G S
GS
Rapidou
C A
CA
Alivizatos
G J
GJ
Deliveliotis
C
C
Constantinides
C A
CA
Theodorou
C
C
D001676:Biofeedback, Psychology / Q000379:methods*; D004576:Electromyography; D005081:Exercise Therapy / Q000379:methods*; D030141:Feedback, Psychological / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017773:Pelvic Floor; D011468:Prostatectomy / Q000379:methods* / Q000534:rehabilitation; D011471:Prostatic Neoplasms / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D014549:Urinary Incontinence / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D014554:Urination / Q000502:physiology