title: Evaluation of pelvic floor muscle strength before and after robotic-assisted radical prostatectomy and early outcomes on urinary continence.
abstract: The aim of the study was to evaluate the effect of pelvic floor muscle (PFM) assessment and training before and after robot-assisted laparoscopic radical prostatectomy (RARP) in improving PFM strength and urinary continence. We performed an analysis of a database of patients who underwent robot-assisted laparoscopic radical prostatectomy (RARP) performed by two urologists from 2011 to 2013. Pelvic floor muscle (PFM) activation and strength were graded by a trained pelvic floor physiotherapist. Patients were given an exercise program, grouped according to the strength of their pelvic floor as graded by assessment, to complete before and after surgery. PFM strength was recorded preoperatively, 4 days post-catheter removal and 4 weeks post-catheter removal. Continence was recorded at 4 weeks postop and was defined as the requirement of no continence aids. A total of 98 patients had RARP and a preoperative physiotherapy assessment plus postoperative appointments at around 1 and 4 weeks post-RARP. The majority of men improved their PFM strength regardless of preoperative strength with no significant predictors of postoperative strength found. Age was the only significant predictor of postoperative incontinence. In this pilot study, a majority of patients increased their pelvic floor strength with time. Pelvic floor physiotherapy is an important modifiable patient factor, which does have an impact in improving patients' urinary continence by strengthening the pelvic floor muscles. Patient age influences response to pelvic floor physiotherapy.
authors.affiliation: University of Notre Dame, Werribee Clinical School, Melbourne, Australia.
authors.forename: Lauren
authors.initials: L
authors.lastname: Manley
authors.affiliation: Urology Unit, Department of Surgery, Austin Hospital, University of Melbourne, 145 Studley Rd, Heidelberg, Melbourne, Victoria, 9496 5000, Australia. lukedgibson@gmail.com.
authors.forename: Luke
authors.initials: L
authors.lastname: Gibson
authors.affiliation: Urology Unit, Department of Surgery, Austin Hospital, University of Melbourne, 145 Studley Rd, Heidelberg, Melbourne, Victoria, 9496 5000, Australia.
authors.forename: Nathan
authors.initials: N
authors.lastname: Papa
authors.affiliation: Urology Unit, Department of Surgery, Austin Hospital, University of Melbourne, 145 Studley Rd, Heidelberg, Melbourne, Victoria, 9496 5000, Australia.
authors.forename: Bhawanie Koonj
authors.initials: BK
authors.lastname: Beharry
authors.affiliation: Pelvic Strength Physiotherapy, Croydon, Australia.
authors.forename: Liana
authors.initials: L
authors.lastname: Johnson
authors.affiliation: Urology Unit, Department of Surgery, Austin Hospital, University of Melbourne, 145 Studley Rd, Heidelberg, Melbourne, Victoria, 9496 5000, Australia.|Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
authors.forename: Nathan
authors.initials: N
authors.lastname: Lawrentschuk
authors.affiliation: Urology Unit, Department of Surgery, Austin Hospital, University of Melbourne, 145 Studley Rd, Heidelberg, Melbourne, Victoria, 9496 5000, Australia.|Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
authors.forename: Damien M
authors.initials: DM
authors.lastname: Bolton
mesh_terms: D000367:Age Factors; D000368:Aged; D005081:Exercise Therapy / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D017773:Pelvic Floor / Q000502:physiology*; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000503:physiopathology / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology
keywords: Pelvic floor; Prostatectomy; Prostatic neoplasms; Urinary incontinence