Effectiveness of early pelvic floor rehabilitation treatment for post-prostatectomy incontinence.
OBJECTIVE
Urinary incontinence after radical prostatectomy is a significant clinical problem. In this prospective study we investigate the effectiveness of early pelvic floor muscle training (PFMT) on a large population, that had undergone radical retropubic prostatectomy (RRP) at our department.


METHODS
300 consecutive patients who had undergone RRP for clinically confined prostate cancer were randomized in two groups after catheter removal. One group of 150 patients took part in a structured PFMT program. This began before discharge and consisted of Kegel exercises. The remaining 150 patients constituted the control group, they were not formally instructed in PFMT. Incontinence was assessed objectively using the 1 hour and 24 hour pad test, as well as with the ICS-Male questionnaire. All patients who were incontinent after 6 months underwent urodynamic evaluation.


RESULTS
In the treated group, 19% (29 patients) achieved continence after 1 month, and 94.6% (146 patients) after 6 months. In the control group 8% (12 patients) achieved continence after 1 month, and 65% (97 patients) after 6 months (p<0.001). Patient age did not correlate with continence in the control group (p>0.05), although a significant correlation was revealed within the treated group (p<0.01). Overall, 93.3% of the total population achieved continence after one year.


CONCLUSIONS
After RRP an early supportive rehabilitation program like PFMT significantly reduces continence recovery time.
Clinica Urologica II, University of Florence, Viale Pieraccini, 18, 50139, Florence, Italy.
Maria Teresa
MT
Filocamo
Vincenzo
V
Li Marzi
Giulio
G
Del Popolo
Filippo
F
Cecconi
Michele
M
Marzocco
Aldo
A
Tosto
Giulio
G
Nicita
D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D017773:Pelvic Floor / Q000502:physiology*; D011468:Prostatectomy / Q000009:adverse effects / Q000534:rehabilitation*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology / Q000534:rehabilitation*; D014563:Urodynamics