1365 EFFECT OF PREOPERATIVE PELVIC FLOOR MUSCLE THERAPY VERSUS STANDARD CARE ON STRESS URINARY INCONTINENCE IN MEN UNDERGOING RADICAL LAPAROSCOPIC PROSTATECTOMY

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence, Evaluation & Therapy (III)1 Apr 20131365 EFFECT OF PREOPERATIVE PELVIC FLOOR MUSCLE THERAPY VERSUS STANDARD CARE ON STRESS URINARY INCONTINENCE IN MEN UNDERGOING RADICAL LAPAROSCOPIC PROSTATECTOMY Petra Voorham- van der Zalm, Joke Dijkstra- Eshuis, Rosa Splinter, Hein Putter, Rob F.M. Bevers, and Rob C.M. Pelger Petra Voorham- van der ZalmPetra Voorham- van der Zalm Leiden, Netherlands More articles by this author , Joke Dijkstra- EshuisJoke Dijkstra- Eshuis Leiden, Netherlands More articles by this author , Rosa SplinterRosa Splinter Leiden, Netherlands More articles by this author , Hein PutterHein Putter Leiden, Netherlands More articles by this author , Rob F.M. BeversRob F.M. Bevers Leiden, Netherlands More articles by this author , and Rob C.M. PelgerRob C.M. Pelger Leiden, Netherlands More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2719AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoscopic Radical prostatectomy (LRP) is one of the treatments of organ confined prostate cancer. Stress urinary incontinence (SUI) could be a consequence of this treatment. SUI is the complaint of involuntary loss of urine on effort or physical exertion. Dysfunction of the bladder neck as well as intra operative damage of the nerves and sphincter may play a causative role. In this regard, damage of the urethral sphincter can result both from direct damage to the muscle or the neurovascular bundles. When achieving continence the pelvic floor could play a major role. Whether pelvic floor muscle therapy (PFMT) given prior to the RP could decrease the incidence of SUI after this procedure, is a matter of debate in literature at present. The aim of this study is to investigate the effectiveness of PFMT on SUI in men planned to undergo a LRP. METHODS Patients scheduled to undergo a LRP are randomized into a group that will receive preoperative PFMT(inclusive biofeedback) or into a control group. Validated questionnaires, the Pelvic Floor Inventories (PelFIs), the King's Health Questionnaire (KHQ), the International Prostate Symptom Score (IPSS), a voiding dairy, a 24h pad test and examination of the pelvic floor are used to determine the effect of preoperative PFMT on SUI. Six weeks, three months, six months, nine months and one year postoperatively both groups are requested to fill in the KHQ, IPSS and the 24h voiding diary again and to conduct a 24h pad test. In addition, the PelFIs is administered one year postoperatively and the quantitative and qualitative examination of the pelvic floor is repeated. Continence has been defined as completely dry. RESULTS Of 110 patients the results have been analyzed one year postoperatively. The mean age was 63.6 years (range 51-75 years), the mean prostate specific antigen was 10.9 μg/l and over 90% of the patients had a T1 or T2 stage. In the KHQ, IPSS and pad tests the score changed significantly over time (p=0.0001. There were no significant differences between the intervention group and the control group in the incidence of SUI for the KHQ, IPSS and pad tests (p= > 0.05). Continence was achieved in 19,5% of the patients at 6 weeks , 43,2 % at 3 months, 66,1 % at 6 months, 79,7 % at nine months and 83,9 % at one year. In total 16,1 % of the patients was still incontinent one year post operatively. CONCLUSIONS Preoperative PFMT is not effective in the prevention of SUI after a LRP. Other confounders play a major role in achieving continence after LRP. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e558-e559 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Petra Voorham- van der Zalm Leiden, Netherlands More articles by this author Joke Dijkstra- Eshuis Leiden, Netherlands More articles by this author Rosa Splinter Leiden, Netherlands More articles by this author Hein Putter Leiden, Netherlands More articles by this author Rob F.M. Bevers Leiden, Netherlands More articles by this author Rob C.M. Pelger Leiden, Netherlands More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...