title: Effect of preoperative pelvic floor muscle therapy with biofeedback versus standard care on stress urinary incontinence and quality of life in men undergoing laparoscopic radical prostatectomy: a randomised control trial.
abstract: OBJECTIVE
  Laparoscopic radical prostatectomy (LARP) may cause stress urinary incontinence (SUI). This study reports the effects of preoperative pelvic floor muscle therapy (PFMT) on SUI and quality of life (QoL) in men undergoing LARP.
  
  
  METHODS
  In this single-center randomized controlled trial, 122 patients undergoing LARP were assigned to an intervention group of PFMT with biofeedback once a week preoperatively, with 4 weeks' follow-up or to a control group receiving standard care. Randomization and allocation to the trial group were carried out by a central computer system. The primary analysis was based on 121 (n = 65; n = 56), comparing SUI rates and QoL in the two groups in a 1-year follow-up. Validated questionnaires, the Pelvic Floor Inventories (PeLFls), the King's Health Questionnaire (KHQ), the International Prostate Symptom Score (IPSS), a bladder diary, a 24-hr pad test and pelvic floor examination were used. Continence was defined as no leakage at all. All analyses were performed according to intention-to-treat.
  
  
  RESULTS
  One hundred twenty-two patients were randomized, 19 patients were excluded from analysis because of early drop-out. There were no significant differences between both groups in the incidence of SUI and QoL based on the KHQ, IPSS, and pad tests (P ≥ 0.05). In all patients continence was achieved in 77.2% at 1 year postoperatively.
  
  
  CONCLUSIONS
  Preoperative PFMT does not appear to be effective in the prevention of SUI and QoL following LARP.
authors.affiliation: Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Joke
authors.initials: J
authors.lastname: Dijkstra-Eshuis
authors.forename: Tine W L
authors.initials: TW
authors.lastname: Van den Bos
authors.forename: Rosa
authors.initials: R
authors.lastname: Splinter
authors.forename: Rob F M
authors.initials: RF
authors.lastname: Bevers
authors.forename: Willemijn C G
authors.initials: WC
authors.lastname: Zonneveld
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.forename: Rob C M
authors.initials: RC
authors.lastname: Pelger
authors.forename: Petra J
authors.initials: PJ
authors.lastname: Voorham-van der Zalm
mesh_terms: D000368:Aged; D001676:Biofeedback, Psychology / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D053580:Muscle Strength / Q000502:physiology; D009132:Muscles / Q000502:physiology; D017773:Pelvic Floor / Q000502:physiology*; D026741:Physical Therapy Modalities; D011300:Preoperative Care / Q000379:methods*; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*
keywords: biofeedback; laparoscopic radical prostatectomy; pelvic floor; physiotherapy; stress urinary incontinence