Результаты тренировки мышц тазового дна под контролем биологической обратной связи пациентов с недержанием мочи после открытой, лапароскопической и робот-ассистированной радикальной простатэктомии

Abstract

Objective. To compare the results of learning isolated pelvic floor muscle contractions with the use of biofeedback and its effectiveness for recovery of urinary continence in patients with urinary incontinence after open, laparoscopic and robot-assisted laparoscopic radical prostatectomy. Patients and methods. We used pelvic floor muscle training combined with biofeedback control in 204 patients with incontinence after prostatectomy. 144 patients (70.6 %) underwent retropubic prostatectomy, 44 patients (21.6%) laparoscopic, and 16 (7.8%) received robot-assisted radical prostatectomy. In all patients surgery was performed using a nerve-sparing technique. Results. As a result of training, 164 (80.4%) patients acquired a practical skill of isolated contractions and could practice them on their own. The other 40 (19.6%) needed regular support with the use of biofeedback 1–2 times a month in the settings of an outpatient department. The type of surgery did not influence training. By the sixth month of follow-up, in the group with the acquired skill of isolated contractions recovery of continence was noted in 2 (1.0%), improvement in 105 (51.5%), while 57 (27.9%) had no changes. In patients who had no skill of isolated contraction of pelvic floor muscles the figures were 1 (0.5%), 17 (8.3%) and 22 (10.8%), respectively. Conclusion. The possibility of management and retraining did not depend on the patient’s functional state after surgery. The terms of recovering urinary continence by the sixth month of follow-up by training pelvic floor muscles with biofeedback after open, laparoscopic and robot-assisted prostatectomy did not differ. Key words: urinary incontinence, muscle training