Abstract
Aim: The aim of this study was to assess the impact of pelvic floor muscle training (PMFT) in the treatment of stress urinary incontinence (SUI) in men after they received radical prostatectomy (RP). Methods: From November 2018 to September 2019, patients who underwent radical prostatectomy were assessed for eligibility. A total of 37 men were then randomly assigned to the experimental group (EG) and the control group (CG). The EG group received supervised exercise twice a week for 12 weeks, and the CG did not receive any intervention. To objectify the results obtained in both groups before and after the intervention, the authors assessed myostatin concentration. Moreover, the Expanded Prostate Cancer Index Composite (EPIC-26) was applied to assess the quality of life, and Beck’s Depression Inventory (BDI-II) was used to measure depression severity. Results: Study results demonstrated a statistically significant reduction of myostatin concentration in the EG following the treatment and no statistically significant differences in this parameter in the CG. In addition, a comparison of the EPIC-26 scores in the EG at the initial and final assessments revealed a statistically significant improvement in the quality of life in each domain. A comparison of the EPIC-26 scores in the CG at the initial and final assessments showed there is a statistically significant decline in quality of life in the “overall urinary problem” and “sexual” domain. A comparison of the BDI-II scores at the initial and final assessments showed a statistically significant decline in depressive symptoms in the EG and no statistically significant differences in the CG. Conclusions: PFMT is an effective treatment for urinary incontinence (UI) in men who received radical prostatectomy.
Highlights
Prostate cancer represents the second most common malignant tumor following lung cancer in men
Study inclusion criteria were as follows: patients after laparoscopic radical prostatectomy; stress urinary incontinence diagnosed by a urologist and based on urodynamic examination results; recent therapeutic interventions in pelvic floor performed within 6 months prior to the study (PFMT, magnetotherapy, electrostimulation, and biofeedback); no contradictions to the treatment; written consent to the study
A statistically significant reduction of myostatin concentration was observed in the experimental group (EG) (p < 0.001) following PFMT, and no statistically significant differences in this parameter were observed in the control group (CG) (p = 0.339) at the final assessment
Summary
Prostate cancer represents the second most common malignant tumor following lung cancer in men. One of the therapeutic options for patients in good condition is radical surgical removal of the prostate gland—radical prostatectomy. The removal of the prostatic segment of the urethra and its smooth muscle (internal sphincter) during radical prostatectomy may damage the striated urethral sphincter or its innervation. Inhibition of GDF-8 functions may be a useful strategy in treating stress urinary incontinence This theory was confirmed in our previous research conducted on women with stress urinary incontinence, in which we observed a statistically significant reduction of myostatin concentration following various methods of activating pelvic floor muscles, such as pelvic floor muscle training and extracorporeal magnetic innervation (ExMI) [17,18]. The objective of this study was to evaluate the effectiveness of pelvic floor muscle training in patients who received radical prostatectomy and to examine its biochemical parameters. Guided by the biopsychosocial model of health, the authors aimed to assess the quality of life of the study participants
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