Применение метода биологической обратной связи в лечении больных с недержанием мочи после радикальной простатэктомии.

Abstract

Introduction. Pelvic floor muscle training (PFMT) is the first line of treatment for urinary incontinence after radical prostatectomy. To improve the results of PFMT the biofeedback method is used, while there is no consensus in the scientific literature regarding its effectiveness. Objective: to evaluate the effectiveness of PFMT and biofeedback method for restoring urinary continence in patients after radical prostatectomy. Materials and methods. 47 men with urinary incontinence developed after radical prostatectomy were under observation. Patients of the 1st group (n=24) were recommended to perform PFMT at home 3 times a day for 15 minutes for 6 months. Patients of the 2nd group (n=23) also performed PFMT at home for 6 months, but during the first month they additionally performed exercises for the pelvic muscles on the stationary hardware-software biofeedback complex Uroproctocor" once a week for 40 min. The effectiveness of treatment was assessed using the ICIQ-SF questionnaire, 1- and 24-hour pad tests and urine interruption test. Results. 1 month after the start of treatment a significant decrease in the severity of urinary incontinence was reported by 58.3% of patients in the 1st group and 82.6% of patients in the 2nd group. At the same time, patients of the 2nd group used a significantly smaller number of pads and had a higher quality of life compared to patients of the 1st group. The skill of isolated contraction of the pelvic floor muscles was acquired by 73.9% of patients of the 2nd group, and it was in them that the effectiveness of treatment turned out to be the greatest. The rest of the patients of the 2nd group continued biofeedback therapy in the mode of 1 session every 2 weeks. By the 6th month of observation, improvement was noted in 70.8% of patients of the 1st group and 91.3% of patients of the 2nd group. Conclusions. The use of the biofeedback method increases the effectiveness of PFMT in patients with urinary incontinence after radical prostatectomy. The biofeedback method makes it possible to teach the patient how to properly perform PFMT, which increases their effectiveness, helps to reduce the duration of treatment and improves the quality of life of patients.