Introduction and Objectives
Urinary incontinence following radical prostatectomy (RP) continues to be a distressing problem with severe impact on the quality of patient's life. Incontinence has been reported in 2% to 87% of men after radical prostatectomy depending on the definitions, diagnosis modalities and interval from surgery. Aim of the study is to describe the effect of intensive pelvic floor muscle training after RP to continence outcomes.
Material and Methods
Fifty eight men aged 53 to 74 years (median 66 years) were included in the study between November 2006 and September 2008. All patients underwent open, nerve sparing RP by different surgeons. The patients were divided into two groups. Group A with 30 men, followed an intensive treatment consisted of a structured 12-week program including patient education and positive reinforcement techniques administered by trained nurses. In group B, the 28 patients were informed how to contract correctly their muscles and were encouraged to perform three sets of pelvic floor muscle contractions daily. groups were analysed on an intention-to-treat basis by ANOVA and chi2-test.
Continence outcome was evaluated by the use of pads and the urinary leakage (gr) at 24 h pad test at 1, 3 and 6 months after surgery. At 1 month follow up, the continence status was similar in group A and group B. At 3 and 6 month follow up there was a significantly higher number of continent patients in group A compared to group B. In the intensive treatment group A continence was achieved after 3 months in 90% of patients. In group B, continence returned after 3 months in 54% of 28 patients. At 6 months the continence rates were 95% and 74% respectively.
Intensive pelvic-floor muscle training should be considered as a first-line option in curing incontinence after radical prostatectomy.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.