Pelvic floor muscle training before transurethral resection of the prostate: a randomized, controlled, blinded study.
OBJECTIVE To evaluate the effect of preoperative pelvic floor muscle training (PFMT) in men scheduled for transurethral resection of the prostate (TURP) in a randomized, single-blind study.


METHODS
Fifty-eight men with benign prostatic obstruction were included, and 49 completed the study (training group, n=26; control group, n=23). The preoperative training included a 1-h individual lesson, three 1-h group lessons and a home training programme. Postoperatively and before discharge from hospital both groups received verbal instructions regarding PFMT. Pelvic floor muscle function was assessed by anal examination before and 4 weeks after surgery by one physiotherapist who was blinded to the randomization. The primary outcome parameter was the total score on the Danish Prostatic Symptom Score questionnaire. Secondary outcome measures were other subjective and objective voiding and incontinence parameters and four tests of the pelvic floor muscle: function; strength; static endurance; and dynamic endurance.


RESULTS
Baseline characteristics were similar in the two groups. Improved static endurance occurred in the training group but not in the control group (p=0.004). Regarding dynamic endurance, a difference in favour of training developed between the groups (p=0.049). Many men produced results that were outside the test scales. At follow-up at 2 and 4 weeks and 3 months there were no differences between the groups in any of the lower urinary tract parameters.


CONCLUSIONS
Preoperative PFMT produced a significant improvement in pelvic floor muscle endurance after TURP, but clinically relevant storage or voiding improvements did not occur. Pelvic floor muscle assessment tests need to be sex-specific.
Tibaek
Sigrid
S
Department of Geriatrics and Rheumatology, Copenhagen University Hospital, Glostrup, Nordre Ringvei, DK-2600 Glostrup, Denmark. Sigrid.Tibaek@get2net.dk
Klarskov
Peter
P
Lund Hansen
Bente
B
Thomsen
Hanne
H
Andresen
Helle
H
Schmidt Jensen
Christiane
C
Niemann Olsen
Mette
M
D000368:Aged; D005081:Exercise Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000502:physiology*; D017773:Pelvic Floor; D011300:Preoperative Care; D011470:Prostatic Hyperplasia / Q000601:surgery; D016037:Single-Blind Method; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000517:prevention & control*