title: The relationship between continence and perineal body tone before and after radical prostatectomy: a pilot study.
abstract: BACKGROUND
  Recent preliminary studies showed that tonic-trophic characteristics of the pelvic muscles are related to postoperative male urinary incontinence. The aim of the current study was to test whether perineal body tone (PBT), evaluated using the Beco perineometer (Perineocaliper), is related to urinary continence recovery after robot-assisted laparoscopic prostatectomy (RALP).
  
  
  METHODS
  The study population consisted of 48 patients who underwent RALP between January and July 2009. Surgical interventions were performed by a single surgeon and patients were evaluated by a single physiotherapist. All patients were taught pelvic floor muscle exercises (PFME). PBT was evaluated in each patient preoperatively, as well 30 days and 3 months after surgery. In addition, patients were evaluated with a 24-hr pad-test and the International Consultation on Incontinence-questionnaire (ICI-Q).
  
  
  RESULTS
  Mean age at surgery was 65.5 years (range 46-63). Twenty-four patients underwent a bilateral nerve-sparing procedure (50%). One-month after surgery, 25 (52.1%) patients were continent while 23 (47.9%) patients were still incontinent. A statistically significant difference in preoperative perineometric measures was observed between continent and incontinent patients (mean 1.36 cm vs. 0.80 cm; P < 0.001). This difference was even more pronounced when comparing postoperative perineometric measures (mean 1.24 cm vs. 0.43 cm; P < 0.001). Evaluation of patients 3 months after surgery showed an increase in perineometric measures (mean increase 0.76 cm). The increase was significantly higher in patients who became continent after 3 months relative to patients who were still incontinent despite PFME (mean perineometric measures 1.45 cm vs. 1.00 cm; P = 0.021).
  
  
  CONCLUSIONS
  Our results demonstrate that urinary continence recovery is related to PBT recovery. Further studies are needed to confirm whether perineometric measures may be used as a predictive tool for the risk-stratification of postoperative UI.
authors.affiliation: Department of Urology, Vita-Salute San Raffaele University, San Raffaele Turro, Milan, Italy. lorenzorigatti@libero.it
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Rigatti
authors.forename: Antonia
authors.initials: A
authors.lastname: Centemero
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lughezzani
authors.forename: Alessandro
authors.initials: A
authors.lastname: Larcher
authors.forename: Donatella
authors.initials: D
authors.lastname: Giraudo
authors.forename: Emanuele
authors.initials: E
authors.lastname: Scapaticci
authors.forename: Mattia
authors.initials: M
authors.lastname: Sangalli
authors.forename: Giuliana
authors.initials: G
authors.lastname: Lista
authors.forename: Massimo
authors.initials: M
authors.lastname: Lazzeri
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.forename: Patrizio
authors.initials: P
authors.lastname: Rigatti
authors.forename: Giorgio
authors.initials: G
authors.lastname: Guazzoni
mesh_terms: D005081:Exercise Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology* / Q000601:surgery; D010502:Perineum / Q000503:physiopathology* / Q000601:surgery; D010865:Pilot Projects; D011467:Prostate / Q000601:surgery; D011468:Prostatectomy / Q000009:adverse effects / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*