Abstract
BackgroundRadical prostatectomy is the gold standard treatment for men with localized prostate cancer. This technique is associated with post-operative urinary incontinence. Pelvic floor physiotherapy is a conservative, painless and economical treatment for this specific situation. Kegel exercises and perineal electrostimulation are common techniques to train pelvic floor muscles. The perineal electrostimulation can be applied to the patient with surface electrodes or by an intra-cavitary anal probe. This study proposes that transcutaneous perineal electrostimulation is as effective as intra-cavitary electrostimulation in reducing urinary incontinence secondary to radical prostatectomy. The main objective is to compare the efficacy of the treatment with transcutaneous perineal electrostimulation versus the same intra-cavitary treatment to reduce the magnitude of urinary incontinence after radical prostatectomy, and the impact on the quality of life.MethodsThis single-blind equivalence randomized controlled trial will include 70 man who suffer urinary incontinence post radical prostatectomy. Participants will be randomized into surface electrodes group and intra-anal probe group. The groups will receive treatment for 10 consecutive weeks. Outcomes include changes in the 24-h Pad Test, and ICIQ-SF, SF-12 and I-QoL questionnaires. Clinical data will be collected at baseline, 6 and 10 weeks after the first session, and 6 months after the end of treatment.DiscussionThe results will allow us to prescribe the most beneficial perineal electrostimulation technique in the treatment of urinary incontinence derived from radical prostatectomy.Trial registrationClinicalTrials.gov Identifier: NCT03587402. 27/06/2018
Highlights
Radical prostatectomy is the gold standard treatment for men with localized prostate cancer
Radical prostatectomy (RP) is associated with post-operative urinary incontinence (UI), that can persist for two years or longer and is associated to significant reductions in overall health-related quality of life (QoL) [2,3,4,5]
Urinary continence in men depends on the contributions from smooth muscle of the urethra and urethral constriction generated by contraction of three striated muscles: the striated urethral sphincter (SUS); puborectalis/pubovisceralis and bulbocavernosus [6]
Summary
Radical prostatectomy is the gold standard treatment for men with localized prostate cancer. This technique is associated with post-operative urinary incontinence. This study proposes that transcutaneous perineal electrostimulation is as effective as intra-cavitary electrostimulation in reducing urinary incontinence secondary to radical prostatectomy. The main objective is to compare the efficacy of the treatment with transcutaneous perineal electrostimulation versus the same intra-cavitary treatment to reduce the magnitude of urinary incontinence after radical prostatectomy, and the impact on the quality of life. Radical prostatectomy (RP) is the gold standard treatment for men with localized prostate cancer and prostatic hyperplasia. Urinary continence in men depends on the contributions from smooth muscle of the urethra and urethral constriction generated by contraction of three striated muscles: the striated urethral sphincter (SUS); puborectalis/pubovisceralis and bulbocavernosus [6]. Continence recovery after prostatectomy is likely to require enhanced function of SUS (and other striated muscles) to compensate for the reduced smooth muscle [6, 7]
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