Pelvic Floor Muscle Rehabilitation Research Articles

Virtual reality gaming for rehabilitation of patients with urinary incontinence: A systematic review and meta-analysis.

Urinary Incontinence (UI) is a global health issue that mainly affects the female population worldwide. Different approaches have been sought for the management of UI including Pelvic floor muscle training (PFMT) using Virtual Reality (VR) gaming. We conducted this study to evaluate the effectiveness of VR gaming for rehabilitation of pelvic floor muscles (PFM) and improving urinary symptoms in patients with UI. We've included studies that contain any type of VR in all geographic locations and settings with no restrictions on the date of publication, age, or gender. Our exclusion criteria include reviews, case series, case reports, unextractable data, unavailable full text, abstract only articles, and studies don't show the effects of VR as a treatment for UI. A pre-specified search term was used and modified according to the requirements of each of the following databases: PubMed, Web of Science, Scopus, Cochrane, Google scholar, and ScienceDirect. For risk of bias assessment, two assessment tools have been used: ROB 2.0 for RCTs and NIH for single arm studies. Of 915 papers identified from 6 databases, 341 papers were assigned for screening after removing duplicates, 11 papers were eligible for full text screening, and 4 papers were finally included. The qualitative analysis of the results identifies six outcomes grouped into three primary categories: PFM, urinary symptoms, and quality of life. Only urinary loss outcome was eligible for meta-analysis. The net effect between Game therapy+PFMT and PFMT reached MD=-5.49, 95% CI [-12.36:1.38] (heterogeneity; I2=95%, p<0.01). Our research underscores the potential of VR gaming as a valuable adjunctive therapy for pelvic floor muscle rehabilitation in patients with UI. However, further studies are needed to explore its long-term effectiveness, optimal therapy parameters, and cost-effectiveness. Our protocol has been registered in PROSPERO (CRD42022384500).

197 - Multicentre study on premature ejaculation treatment with pelvic floor muscle rehabilitation: analysis of 5 years follow-up outcomes

197 - Multicentre study on premature ejaculation treatment with pelvic floor muscle rehabilitation: analysis of 5 years follow-up outcomes

33 - Multicentre study on premature ejaculation treatment with pelvic floor muscle rehabilitation: Analysis of 5 years results

33 - Multicentre study on premature ejaculation treatment with pelvic floor muscle rehabilitation: Analysis of 5 years results

(126) Application of HIFEM Therapy Improves Orgasmic, Urinary and Erectile Function by Stimulation of Pelvic Floor Muscles

Abstract Introduction The weak pelvic floor in men contributes to various urological disorders. Treatment can be accomplished by strengthening the pelvic floor muscles (PFM) through pelvic floor muscle training. Nevertheless, such development of PFM is time-consuming and heavily dependent on the subject's ability to perform selective muscle contractions. An advantageous approach is the targeted stimulation of PFM which can be accomplished via electromagnetic stimulation. Particularly, the pelvic floor muscles can be non-invasively and selectively stimulated via the HIFEM field. This results in the natural development and rehabilitation of PFM, which, among other functions, plays a vital role in facilitating orgasmic, urinary and erectile function. Objective The aim of this study is to assess the safety and efficacy of the HIFEM pelvic procedure for the treatment of erectile dysfunction. Methods In this study, 28 males with a median age of 56 (30-72 years) were enrolled. The treatment was composed of ten weekly 28-minute sessions. Outcome measurements were collected via questionnaires and ultrasound imaging prior to and after the last treatment. To assess changes in erectile and sexual function, and prostate-related symptoms, the International Index of Erectile Function (IIEF) and International Prostate Symptom Score (IPSS) were used. Transverse B-Mode ultrasound video scans were recorded along the long axis of the penile shaft from the tip to the base with the penis in a flaccid state. A linear transducer was used, the depth was set at 2 cm, and the frame rate was approximately 30 frames per second. Separate video recordings of the left and right cavernosum were taken. The ultrasound scans were processed by the Morphometrix cloud-based algorithm. Adverse events were monitored during the study. Results All evaluation methods proved the efficiency of treatment on a statistically significant level. A significant improvement was detected in the majority (4 of 5) of the domains of IIEF, with the overall score improvement from a baseline value of 45.14±2.42 to 48.75±2.86 (+3.61 points). The most exceptional improvement was found in Sexual desire (+18.78%; p=1.06x10-3), Erectile dysfunction (+13.03%; p=5.7x10-4), and Orgasmic function (+10.69%; p=7.04x10-5) domains. The mean difference in the total score of the IPSS questionnaire reached -3.04 points (p=5.1x10-6), exceeding the corresponding minimal clinical difference (MIC=3 points). Overall, subjects, on average, shifted from moderately symptomatic (9.57±1.37 points) to mildly symptomatic (6.54±0.91 points). An increase in vascularity of both cavernosal was measured within 57% of patients who underwent ultrasound examination; specifically, a significant improvement was recorded in tissue segment count (TSC; +104%; p=1.17x10-4) and density (TSD; +81% p=2.20x10-3), pointing to better blood flow and delivery in examined tissues. No adverse event was observed. Conclusions The therapy administering HIFEM technology of the pelvic floor for selective PFM stimulation demonstrated significant improvement of erectile and orgasmic function and urinary symptoms. The questionnaire results corresponded with ultrasound measurements using a novel algorithm, identifying positive changes in the penile vascular system. Overall, the treatment may be considered a safe and a possible first-line solution for male patients suffering from dysfunctions linked to weakened pelvic floor muscles. Further investigation is needed. Disclosure Yes, this is sponsored by industry/sponsor: BTL. Clarification: Industry funding only - investigator initiated and executed study. Any of the authors act as a consultant, employee or shareholder of an industry for: AFFIRM Science.

The effect of using mobile phone applications for intelligent pelvic floor rehabilitation on elderly female patients with stress urinary incontinence.

Stress urinary incontinence is prevalent among women and the incidence increases with age. To explore the effect of intelligent pelvic floor muscle rehabilitation on elderly female patients with incontinence. A total of 209 patients with urinary incontinence who were treated with pelvic floor muscle rehabilitation at Peking University International Hospital from September 2020 to January 2022 were selected by convenient sampling. All subjects were divided into the 50-60 year old patient group (n= 51) and over 60 years old patient group according to age (n= 158). The subjects of different age group were divided into an experimental group and a control group. The patients in the control group received routine nursing and health education, and the patients in the observation group received a combination of mobile application use and smart dumbbells. Based on this, we constructed an intervention model for intelligent, continuous pelvic floor rehabilitation. After 7 and 12 weeks, pelvic floor muscle function knowledge and exercise compliance in the two groups were evaluated. The improvement of urinary incontinence symptoms, pelvic floor muscle strength grades and quality-of-life scales were evaluated. The results showed that pelvic floor knowledge and exercise compliance in the experimental group were better than in the control group at 7 and 12 weeks after intervention (P< 0.05). There was no significant difference in pelvic floor muscle strength and quality of life between the two groups at 7 weeks after intervention (P> 0.05). However, there was a significant difference in pelvic floor muscle strength and quality of life between the two groups at 12 weeks after intervention (P< 0.05). There was no significant difference between different age groups. The intelligent pelvic floor rehabilitation model that combines a mobile application with smart dumbbells can maintain and strengthen the clinical treatment effect for elderly patients with urinary incontinence.

PD11-06 LONG TERM FOLLOW-UP OUTCOMES OF PELVIC FLOOR REHABILITATION IN SUBJECTS SUFFERING FROM LIFELONG PREMATURE EJACULATION: RETROSPECTIVE MULTICENTRE STUDY

You have accessJournal of UrologyCME1 Apr 2023PD11-06 LONG TERM FOLLOW-UP OUTCOMES OF PELVIC FLOOR REHABILITATION IN SUBJECTS SUFFERING FROM LIFELONG PREMATURE EJACULATION: RETROSPECTIVE MULTICENTRE STUDY Antonio Luigi Pastore, Yazan Al Salhi, Andrea Fuschi, Alessia Martoccia, Fabio Maria Valenzi, Alessandro Sciarra, Stefano Salciccia, de Nunzio Cosimo, Andrea Tubaro, Costantino Leonardo, Giorgio Franco, and Antonio Carbone Antonio Luigi PastoreAntonio Luigi Pastore More articles by this author , Yazan Al SalhiYazan Al Salhi More articles by this author , Andrea FuschiAndrea Fuschi More articles by this author , Alessia MartocciaAlessia Martoccia More articles by this author , Fabio Maria ValenziFabio Maria Valenzi More articles by this author , Alessandro SciarraAlessandro Sciarra More articles by this author , Stefano SalcicciaStefano Salciccia More articles by this author , de Nunzio Cosimode Nunzio Cosimo More articles by this author , Andrea TubaroAndrea Tubaro More articles by this author , Costantino LeonardoCostantino Leonardo More articles by this author , Giorgio FrancoGiorgio Franco More articles by this author , and Antonio CarboneAntonio Carbone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003251.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The aim of the study is to investigate the long-term follow-up outcomes of pelvic floor muscle (PFM) rehabilitation in males suffering from lifelong premature ejaculation (LPE). To evaluate LPE, patients were investigated with intravaginal ejaculatory latency time (IELT) and the self-report Premature Ejaculation Diagnostic Tool (PEDT). These two collected data represented the primary outcome endpoints. METHODS: This retrospective study evaluated 227 subjects with LPE diagnosis, and a total of 171 pts out of 227 (75%) completed the training protocol and at least the follow-up of 72 months. At baseline, all participants reported an IELT ≤60 s and PEDT score >11. Participants completed a 12-week program of PFM rehabilitation, including physio-kinesiotherapy treatment, electrostimulation, and biofeedback, with three sessions per week, with 20 min for each component completed at each session. The effectiveness of intervention was evaluated by comparing the geometric means of IELT times and PEDT scores observed from baseline, to 6, and 12 months during the intervention, and at 24, 36, 48, 60 and 72 months postintervention, using a paired sample 2-tailed t-test, including the associated 95% confidence intervals. RESULTS: One hundred seventy-one participants completed the PFM rehabilitation protocol with 36 sessions of PFM. All subjects achieved the control of ejaculation reflex, reporting a mean IELT of 181.4 s and PEDT score of 2.5 at the 12-week endpoint of the intervention, representing an increase from baseline of 54.9 s and 16.6 scores, respectively, for IELT and PEDT (p < 0.0001). Of the 171 participants who completed the 60-month follow-up, 80%, 78%, 74%, 69 and 67% reported a satisfactory ejaculation control maintenance through the follow-up evaluations at 24, 36, 48, 60 and 72 months after completing PFM rehabilitation, respectively. CONCLUSIONS: Our study is the first on LPE treatment with such long-term follow-up (6 years). The results observed are statistically significant and support a role of PFM as an effective and safe therapy in LPE subjects. A prospective randomized study is requested to assess the role of PFM in PE. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e334 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Antonio Luigi Pastore More articles by this author Yazan Al Salhi More articles by this author Andrea Fuschi More articles by this author Alessia Martoccia More articles by this author Fabio Maria Valenzi More articles by this author Alessandro Sciarra More articles by this author Stefano Salciccia More articles by this author de Nunzio Cosimo More articles by this author Andrea Tubaro More articles by this author Costantino Leonardo More articles by this author Giorgio Franco More articles by this author Antonio Carbone More articles by this author Expand All Advertisement PDF downloadLoading ...

MP37-18 A PROSPECTIVE COHORT STUDY DEMONSTRATING EXERCISE EFFECTS FROM HOME BASED PELVIC FLOOR MUSCLE TRAINING TO REHABILITATE NEUROGENIC LOWER URINARY TRACT DYSFUNCTION; 3D REGIONAL EFFECTS

You have accessJournal of UrologyCME1 Apr 2023MP37-18 A PROSPECTIVE COHORT STUDY DEMONSTRATING EXERCISE EFFECTS FROM HOME BASED PELVIC FLOOR MUSCLE TRAINING TO REHABILITATE NEUROGENIC LOWER URINARY TRACT DYSFUNCTION; 3D REGIONAL EFFECTS Lynn Stothers, Andrew Macnab, Naser Hakimi, W. N. J. M. Colier, M. Maresse, and P. Pourabbassi Lynn StothersLynn Stothers More articles by this author , Andrew MacnabAndrew Macnab More articles by this author , Naser HakimiNaser Hakimi More articles by this author , W. N. J. M. ColierW. N. J. M. Colier More articles by this author , M. MaresseM. Maresse More articles by this author , and P. PourabbassiP. Pourabbassi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003275.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Women with neurogenic lower urinary tract dysfunction (NLUTD) rely on pelvic floor muscle rehabilitation therapy (PFMT) to aid continence. However, in NLUTD including spinal cord injury (SCI) PFM function is known to be affected regionally/asymmetrically which is not detected through exam or manometry. Objective: Report clinical translation of a optical PFM system, patient informed design to provide a 3D measures of PFM contractions quantifiable by reoxygenation recovery following sustained maximal voluntary contractions (SMVC) employed in PFMT. METHODS: An optical transvaginal interface was engineered using a circumferential grid of 6 light emitting diodes (LED’s) (wavelengths 750 & 860nm) & 4 photodiode detectors. Engineering design met preferences for size, shape, weight & ergometric features from a prior end user survey (Figure 1) Sampling at 50Hz, changes in oxy and deoxy-hemoglobin concentration (O2Hb/HHb) during PFM contractions monitored in real time, multiple point, from which HbDiff (O2Hb-HHb) is derived. All completed pre/post Qualiveen, were evaluated via NIRS during a standardized sequence of maximum & sustained PFM contractions, engaged in 12 weeks home based PFMT then repeat optical-derived measures of reoxygenation recovery. RESULTS: N=14 women (5 controls 7 NLUTD) 25–82 yrs. Baseline Qualiveen scores range: 0 (controls)-0.7 (NLUTD). Figure 1: output showing post PFMT composite graphics with NIRS data from channels monitoring the right & left sides of both the anterior & posterior segments of the PFM during 3 SMVC’s. All subjects were monitored successfully pre/post PFMT demonstrating 3D detailed functional ability of small segments of the pelvic floor & documenting effects of training. CONCLUSIONS: Optical detection of a validated quantifiable parameter of muscle reoxygenation in the PFM is feasible using this transvaginal optical interface designed based on women with NLUTD end user feedback. The multipoint design allows small regional variations in PFM functionality to be quantified & improvements from PFMT training effects to be measured in NLUTD/SCI to enhance rehabilitation of women living with NLUTD known to impact negatively on quality of life. Source of Funding: Craig H Neilsen Foundation © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e521 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lynn Stothers More articles by this author Andrew Macnab More articles by this author Naser Hakimi More articles by this author W. N. J. M. Colier More articles by this author M. Maresse More articles by this author P. Pourabbassi More articles by this author Expand All Advertisement PDF downloadLoading ...

Long-term efficacy of the pelvic floor muscle rehabilitation for women with stress urinary incontinence.

Stress urinary incontinence is a common disease with many therapeutic ways, but it lacks long-term follow-up. This study aims to conduct a retrospective study on the long-term efficacy of women with mild and moderate stress urinary incontinence after pelvic floor rehabilitation treatment for 3-years so as to provide a more effective treatment plan for this disease. Data were collected from 279 female patients, who were diagnosed with stress urinary incontinence at the Pelvic Floor Rehabilitation Center of the Third Xiangya Hospital of Central South University from January 2017 to January 2019. All patients received health education and were instructed to perform Kegel exercises for 20 min daily at home. According to the treatment pattern, patients were divided into 3 groups as A, B, and C. Group A (n=94) received pelvic floor biofeedback, electrical stimulation and electroacupuncture; Group B (n=99) received pelvic floor biofeedback and electrical stimulation; Group C (n=86) only got pelvic floor function examinations and did not receive any pelvic floor treatment. The pelvic floor functional examinations included a pelvic floor electrophysiological test, pelvic organ prolapse quantitive examination (POP-Q), and stress urinary incontinence severity assessment. All patients were followed up with questionnaire consisting of the International Committee on Urinary Incontinence Questionnaire-Short Form (ICI-Q-SF) and the Quality of Life questionnaire of Urinary Incontinence (I-QOL) before and after the treatment, as well as at 1-, 2-, and 3-years after the treatment (5 times in total). Among the patients who received the treatment, 43 returned to the hospital, including 21 in group A (Group Areturn) and 22 in group B (Group Breturn). Pelvic floor electrophysiological test and POP-Q were performed on the 2 groups. For the leakage rate at the end of the treatment and the following 1-, 2-, and 3-years: Group A<Group B<Group C, and the recurrence rate of their leakage remained stable after 2 to 3 years of the treatment (P<0.05). Meanwhile, there was no significant difference in the I-QOL scores between Group A and Group B at the end of the treatment (P>0.05), but the I-QOL scores of Group A and Group B were much higher than that in Group C (both P<0.05). On the other hand, the I-QOL scores at 1-, 2-, and 3-years after the treatment were Group A>Group B>Group C (all P<0.05). In addition, the ICI-Q-SF scores at the end of the treatment and 1-, 2-, and 3-years after the treatment were Group A<Group B<Group C (P<0.05). There was also a significant effect of delivery on I-QOL and ICI-Q-SF scores after the treatment (P<0.05). Besides, the production method also had an impact on the ICI-Q-SF scores after the treatment (P<0.05). The results of the re-evaluation showed that there was no significant difference in the anterior vaginal wall prolapse score (point Aa) between Group A return and Group Breturn at the end of the treatment, but 3 years later, the score of anterior vaginal wall prolapse in Group Areturn was less than that in Group Breturn (P<0.05). Besides, no significant difference was found in the pelvic floor muscle strength between Group A return and Group Breturn at the end of the treatment (P>0.05). While the pelvic floor muscle strength in Group Areturn was much higher than that in Group Breturn (P<0.05) after 3 years of the treatment. What's more, the pelvic floor muscle potential in Group Areturn was much higher than that in Group Breturn (both P<0.05) at the end of the treatment and after 3 years of the treatment. Compared with pelvic floor biofeedback and electrical stimulation for stress urinary incontinence, electroacupuncture combined with pelvic floor electrical stimulation and biofeedback reveal more remarkable short-term efficacy and more stable long-term efficacy, which can significantly improve the quality of life in female patients.

Pelvic floor muscle training: Novel versus traditional remote rehabilitation methods. A systematic review and meta-analysis on their effectiveness for women with urinary incontinence.

To investigate the effectiveness of supervised remote rehabilitation programs comprising novel methods of pelvic floor muscle (PFM) training for women with urinary incontinence (UI). A systematic review and meta-analysis including randomized controlled trials (RCTs), involving novel supervised PFM rehabilitation programs as intervention groups (e.g., mobile applications programs, web-based programs, vaginal devices) versus more traditional PFM exercise groups (acting as control); both sets of groups being offered remotely. Data have been searched and retrieved from the electronic databases of Medline, PUBMED, and PEDro using relevant key words and MeSH terms. All included study data were handled as reported in the Cochrane Handbook for Systematic Reviews of Interventions and the evaluation of their quality was undertaken utilizing the Cochrane risk-of-bias tool 2 (RoB2) for RCTs. The included RCTs, involved adult women with stress UI (SUI) or mixed urinary incontinence, where SUI were the most predominant symptoms. Exclusion criteria involved pregnant women or up to 6-month postpartum, systemic diseases and malignancies, major gynecological surgeries or gynecological problems, neurological dysfunction or mental impairments. The searched outcomes included subjective and objective improvements of SUI and exercise adherence in PFM exercises. Meta-analysis was conducted and included studies pulled by the same outcome measure. The systematic review included 8 RCTs with 977 participants. Novel rehabilitation programs included mobile applications (1 study), web-based programs (1 study) and vaginal devices (6 studies) versus more traditional remote PFM training, involving home-based PFM exercise programs (8 studies). Estimated quality with Cochrane's RoB2, presented the 80% of the included studies as "some concerns" and the 20% as "high risk." Meta-analysis included 3 studies with no heterogeneity (I2 = 0) across them. Weak-evidenced results presented home PFM training equally effective with novel PFM training methods (mean difference: 0.13, 95% confidence interval: -0.47, 0.73), with small total effect size (0.43). Novel PFM rehabilitation programs presented as effective (but not superior) to traditional ones in women with SUI, both offered remotely. However, individual parameters of novel remote rehabilitation including supervision by the health professional, remains in question and larger RCTs are required. Connection between devices and applications in combination with real-time synchronous communication between patient and clinician during treatment is challenged for further research across novel rehabilitation programs.

A novel radiofrequency modulation therapy versus routine physiotherapy modalities in treatment of myofascial pelvic pain syndrome: a pilot randomized trial.

The current study aimed to compare the effectiveness of novel radiofrequency modulation (RM) therapy with a tailored physiotherapy course for patients with chronic pelvic pain (CPP) of myofascial origin, also known as myofascial pelvic pain syndrome (MPPS). We enrolled 46 patients with myofascial CPP to compare the effectiveness of a 10-session routine physiotherapy course versus a 6-session RM with an integrated device (HIGGS) in alleviating MPPS morbidity and pelvic floor muscle (PFM) rehabilitation. The primary outcome was reduction in pelvic pain after the final session and in the follow-up period 3 months after the final intervention session. The 6-session therapy in the RM group and the manual, biofeedback, and transcutaneous electrical nerve stimulation therapies in the physiotherapy group were similarly effective in reducing pain and improving PFM endurance after the final intervention session in each group, whereas perineometer readings and PFM strength were associated with greater improvements in the physiotherapy group. The results of this study demonstrated comparable effectiveness of RM in the management of MPPS and improvement of PFM function compared to routine physiotherapy programs with fewer sessions of therapy.

The Role of Physiotherapy in Parity-Induced Flatus Incontinence: A Case Report

Gas incontinence also known as Flatus incontinence is a common postpartum anal incontinence which impairs social participation and also lacks established protocol of management. Symptom persistency has been reported after perineal muscles repair due to weakness/ loss in function of the pelvic floor muscles. This case report describes about the importance and effectiveness of Pelvic Floor Muscle Rehabilitation (PMR) in a 28year old primiparous woman, four months postpartum who presented with parity-induced flatus incontinence aggravated after sexual activities at a the Physiotherapy clinic of a state government owned hospital located in the south eastern part of Nigeria. Pelvic Muscle Rehabilitation (PMR) and Stabilization exercises were administered thirty minutes (30mins) to forty-five minutes (45mins) three times (3x), a week (1 week) for four weeks (4weeks). There was a significant reduction in Mark’s (Vaizey) score by more than 2 points at the end of the four weeks of physiotherapy intervention and also patient recorded improvement in all the domains of faecal incontinence quality of life scale, pelvic floor muscle strength (anal squeeze pressure) and pelvic floor muscle function (endurance and coordination).

Effect of early pelvic floor muscle exercises (Kegel's) after Robotic Prostatectomy in Prostate cancer patients.

Post-prostatectomy Urinary incontinence (PPUI) due to open or robotic surgery has a negative impact on patients' psycho-social well-being and leads to altered quality of life (Kielb and Dunn in J Urol 166:958-61, 2001). Sphincteric incompetence overall remains the primary cause of PPUI, and it is believed that direct damage and manipulation intraoperatively could be the probable causes [1] (Bayoud et al. in Int J Urol 22:283-7-10, 2015). Pelvic floor muscle (PFM) rehabilitation appears to be beneficial in hastening the return of continence (Kampen and Poppel in Lancet 355:98-102, 2000). Hence, there is a need to re-educate or strengthen the pelvic floor muscles. To study the return of continence, and time duration required for the pelvic floor muscles to regain strength and endurance, thereby, leading to urinary continence and its effect on the quality of life of patients who have undergone robotic prostatectomy. Pelvic floor muscle grading, a 24h pad test, and an International Prostate symptom scoring (IPSS) were the outcome measures used to assess the effect on incontinence status post-operatively. 69 patients were screened between a duration of 3years, i.e., 2017-2020. Four patients remained incontinent 3months post-surgery. On the contrary, 65 patients regained continence. There is a definitive effect of early Kegel's exercise, the patient gains good pelvic floor muscle strength, portraying a reduction in dribbling or leakage of urine. Also, there is an improvement in the quality of life after Robotic Prostatectomy in Prostate cancer patients after 6weeks of surgery. 94.20% of the patients have shown a have gained continence by 3months post-robotic prostatectomy following a regular exercise regime of Kegel's exercise.

Manual Physiotherapy Combined with Pelvic Floor Training in Women Suffering from Stress Urinary Incontinence and Chronic Nonspecific Low Back Pain: A Preliminary Study.

Stress urinary incontinence (SUI) represents one of the most common subtypes of urinary incontinence (UI) reported by women. Studies have shown an association of SUI with nonspecific low back pain (NSLBP). The primary aim of the present study was to explore the long-term effects of a combined treatment of manual techniques and pelvic floor muscle (PFM) training in women suffering from SUI associated with NSLBP. The secondary aim was to evaluate which manual approach combined with PFM rehabilitation is more effective in improving symptoms related to SUI and in reducing pain perception related to NSLBP. Twenty-six patients suffering from SUI associated with chronic NSLBP were randomly assigned to one of two groups: the postural rehabilitation group (PRg) or the spinal mobilization group (SMg). Both groups performed a manual approach combined with PFM rehabilitation. All patients were evaluated before the treatment (T0), after 10 sessions (T1) and after 30 days from the end of the treatment (T2). The results showed an improvement in both groups in all of the investigated outcomes. Combining manual therapy and PFM training within the same therapy session may be useful for improving both SUI and NSLBP and increasing the quality of life of women suffering from SUI associated with NSLBP.

Physiotherapy and Anterior Resection Syndrome (Paris) Trial A Feasibility Study to Assessing if a Preoperative Education and Physiotherapy Session Before an Anterior Resection, and a 3 Month Pelvic Floor Muscle Rehabilitation Programme Prior to Ileostomy Reversal are Feasible

Physiotherapy and Anterior Resection Syndrome (Paris) Trial A Feasibility Study to Assessing if a Preoperative Education and Physiotherapy Session Before an Anterior Resection, and a 3 Month Pelvic Floor Muscle Rehabilitation Programme Prior to Ileostomy Reversal are Feasible

Three-Dimensional Ultrasound Evaluation of Pelvic Floor Muscle Contraction in Women Affected by Deep Infiltrating Endometriosis: Application of a Quick Contraction Scale.

Using transperineal 3D/4D ultrasound, we evaluated the prevalence of the various categories of a 4-point pelvic contraction scale among women affected by ovarian endometriosis (OE), deep infiltrating endometriosis (DIE), and healthy controls. This prospective study was conducted on nulliparous women scheduled for surgery to remove endometriosis, and nulliparous healthy volunteers who did not show any clinical or sonographic signs of endometriosis, who served as controls. Patients were subjected to 3D/4D transperineal ultrasound obtaining measurements of the antero-posterior diameter (APD), both at rest and during maximal pelvic floor muscle (PFM) contraction (PFMC). The difference of APD from rest to maximal PFMC was then calculated as percent change from baseline (ΔAPD) and patients were thus categorized using the 4-point pelvic contraction scale. One hundred sixty-four patients were considered for the study. Mean difference in APD between relaxed state and maximal PFMC was 23.3 ± 7.9% (range 2.4-40.0) in controls, 20.5 ± 9.0% (range 0.0-37.3) in patients with OE, and 14.6 ± 10.4% (range 0.0-37.1) in patients with DIE (F-test=19.5, P-value < .001). A significant negative correlation was found between the contraction scale and dyspareunia (rs=-0.17, P=.032), and it appeared to be stronger among patients with DIE (rs=-0.20, P=.076). PFM function in endometriotic patients could be assessed reliably through this 4-point scale. The rapid identification of women suffering from PFM dysfunction, along with deep dyspareunia, could enable gynecologists to offer them additional therapies, such as PFM rehabilitation.

PD27-11 PREREHABILITATION CAN IMPROVE URINARY CONTINENCE IN PATIENTS AFTER LAPAROSCOPIC RADICAL PROSTATECTOMY

You have accessJournal of UrologyCME1 May 2022PD27-11 PREREHABILITATION CAN IMPROVE URINARY CONTINENCE IN PATIENTS AFTER LAPAROSCOPIC RADICAL PROSTATECTOMY Aleksandra Juszczak, Tomasz Konecki, Piotr Kutwin, Łowicki Roman, Marcin Cichocki, and Zbigniew Jabłonowski Aleksandra JuszczakAleksandra Juszczak More articles by this author , Tomasz KoneckiTomasz Konecki More articles by this author , Piotr KutwinPiotr Kutwin More articles by this author , Łowicki RomanŁowicki Roman More articles by this author , Marcin CichockiMarcin Cichocki More articles by this author , and Zbigniew JabłonowskiZbigniew Jabłonowski More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002575.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Stress urinary incontinence (SUI) is still one of the major complications after laparoscopic radical prostatectomy (LPR). This is a big problem for patients and physiotherapists. This may happen to most patients soon after surgery. The aim of the study was to assess whether the use of pre-rehabilitation before LRP would reduce the symptoms of SUI. METHODS: 70 patients were included. They were randomly divided into two groups. In group I (n = 36), patients underwent pelvic floor muscle rehabilitation 1 month before surgery and continued rehabilitation after surgery, group II (n = 34) began rehabilitation one month after surgery. Postoperative therapy was the same in both groups. Ultrasound, biofeedback therapy and pelvic floor muscle training were used. Urinary incontinence results were compared between the groups at 1st and 6th months after the procedure. RESULTS: CONCLUSIONS: The implementation of pre-rehabilitation significantly accelerated the results in terms of return to continence in patients after radical prostatectomy in the 1st and 6th month after the surgery. The use of pre-rehabilitation should be considered as a way to improve pelvic floor muscle activity and incontinence outcomes in patients undergoing LRP. Source of Funding: Own © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e497 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aleksandra Juszczak More articles by this author Tomasz Konecki More articles by this author Piotr Kutwin More articles by this author Łowicki Roman More articles by this author Marcin Cichocki More articles by this author Zbigniew Jabłonowski More articles by this author Expand All Advertisement PDF DownloadLoading ...

PD24-04 DETECTION OF PELVIC FLOOR MUSCLE ACTIVITY AND QUANTIFICATION OF OXYGEN KINETICS IN WOMEN WITH SPINAL CORD INJURY AND NEUROGENIC LOWER URINARY TRACT DYSFUNCTION

You have accessJournal of UrologyCME1 May 2022PD24-04 DETECTION OF PELVIC FLOOR MUSCLE ACTIVITY AND QUANTIFICATION OF OXYGEN KINETICS IN WOMEN WITH SPINAL CORD INJURY AND NEUROGENIC LOWER URINARY TRACT DYSFUNCTION Lynn Stothers, and Andrew Macnab Lynn Stothers Lynn Stothers More articles by this author , and Andrew MacnabAndrew Macnab More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002566.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Paralysis and changes in sensation following spinal cord injury (SCI) are a significant barrier to the performance and quantification of pelvic floor muscle (PFM) exercise in women, although international guidelines recommend PFM therapy. Aims: (1) to translate for use in PFM evaluation, a validated optical measure of oxygen kinetics used in sports medicine which uses near infrared (NIR) spectroscopy to quantify the half recovery time of reoxygenation (HbDiff(½RT)) following sustained maximal voluntary muscle contraction (SMVC), and (2) design and test a vaginal interface incorporating NIRS technology specific to the needs of women with compromised PFM function due to SCI. METHODS: The vaginal interface (fig left) incorporates 4 NIRS emitter detector arrays; photons of NIR light (wavelengths 825, 950, 1000 nm) monitor changes in oxygenated and deoxygenated hemoglobin (O2Hb/HHb) at capture rates of 10 Hz during PFM muscle contractions. The study protocol included clinical assessment, bladder diary and Qualiveen symptom scores and perineometry, plus changes in O2Hb/HHb at rest and during PFM rehabilitation exercises. The absolute measure HbDiff(½RT) is derived from the slope of reoxygenation following release of each SMVC. RESULTS: N=15 women aged 25-59 yrs (5 controls, 10 SCI ASIA B, C, D) completed 4 weeks of PFMT; HbDiff(½RT) data sets were compared within individuals and between clinical groups. Repeatability of patterns of recovery were demonstrable within individuals (fig right). CONCLUSIONS: HbDiff(½RT) is a quantifiable absolute measure of skeletal muscle oxygen kinetics; use of the vaginal interface allows individual elements of the PFM to be evaluated; the ability to quantify right and left sided function independently is particularly relevant in women with PFM dysfunction due to partial SCI. Translation of measurement of HbDiff(½RT) to the PFM now allows a validated muscle reoxygenation parameter to be applied in evaluation of PFM dysfunction following SCI in women, and offers a means to quantify clinical training effects from rehabilitation exercise in NLUTD. Source of Funding: Craig Neilsen Foundation © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e416 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lynn Stothers More articles by this author Andrew Macnab More articles by this author Expand All Advertisement PDF DownloadLoading ...

The association between amateur running with varying degrees of effort and sexual function among women.

Sports and physical activity are known risk factors for altered pelvic floor function, which may affect sexual activity. The aim of this study was to examine the impact of amateur running on sexual function. Amateur runners were contacted through social media. Their pelvic floor dysfunction (PFD), sexual function and quality of life were evaluated by self-reported validated questionnaires (PFDI-20, PISQ-12, IIQ-7). They were divided by degrees of effort into 'High effort' and 'Moderate effort.' The differences between the two groups were examined by Mann-Whitney U, t and chi-square tests. One hundred eighty amateur runners were included. No significant differences in the sexual function were found between the two groups. The 'High effort' group reported experiencing higher intensity orgasms compared with women in the 'Moderate effort' group, and a correlation was found between the weekly running distance and intensity of orgasm that they experienced (p = 0.004). High effort physical activity may be associated with improved orgasm, which may be explained by better clitoral circulation and better function of the pelvic floor muscles. Clinicians that treat symptoms related to PFD and sexual dysfunction may raise awareness of the advantages of physical activity and pelvic floor muscle training and rehabilitation, which may improve tone and circulation and hence sexual function.

Construction of pelvic floor muscle rehabilitation training program for patients undergoing laparoscopic radical prostatectomy.

BackgroundLaparoscopic radical prostatectomy (LRP) is the standard treatment for early localized PCa, of which urinary incontinence is the most common postoperative complication. Pelvic floor muscle rehabilitation training is recognized as the first line of intervention measures, but the existing rehabilitation training programs are not clear in the formulation process, the content is not unified, and the clinical operability is not strong. In order to better guide clinical pelvic floor muscle rehabilitation training after LRP and prevent and control urinary incontinence, this study constructed a pelvic floor muscle rehabilitation training program for LRP patients.MethodsLiterature analysis, qualitative interview, and an expert group meeting method were used to form the draft of pelvic floor muscle rehabilitation training program for LRP patients. On this basis, after 2 rounds of Delphi expert consultation, the research team modified and improved the program.ResultsThe consultation experts involved in the 2 rounds were the same, 15 questionnaires were sent out, and 15 were recovered with an effective recovery of 100%. The expert authority coefficient was 0.87. In the second round of consultation, Kendall’s harmony coefficient was 0.14 (P<0.001), the mean coefficient of variation of expert opinion was 0.07 (P<0.001), and the mean value of importance assigned to each item was 4.53–5.00 points. Finally, the pelvic floor muscle rehabilitation training program for LRR patients was formed. Including rehabilitation training evaluation, rehabilitation training advanced time and content, rehabilitation training form of three first-level indicators, 12 second-level indicators, 53 third-level indicators.ConclusionsThe pelvic floor muscle rehabilitation training program for LRP patients developed in this study is scientific, reliable, safe and feasible, which can provide reference for clinical pelvic floor muscle rehabilitation training after LRP and prevention and control of urinary incontinence.

Evaluation of Nursing Effects of Pelvic Floor Muscle Rehabilitation Exercise on Gastrointestinal Tract Rectal Cancer Patients Receiving Anus-preserving Operation by Intelligent Algorithm-based Magnetic Resonance Imaging.

Based on magnetic resonance imaging (MRI) technology under artificial intelligence algorithm, the postoperative nursing effects of pelvic floor muscle rehabilitation exercise on gastrointestinal tract rectal cancer (RC) patients were investigated. A total of 88 patients receiving RC anus-preserving surgery in hospital were selected. The included patients were divided randomly into the experimental group (44 cases) and the control group (44 cases). Patients in the control group engaged in Kegel motion, while patients in the experimental group underwent self-designed comprehensive pelvic floor training. Anorectum function rating scale and quality of life questionnaire for colorectal cancer (EORTC QLQ-CR29) were utilized to compare and analyze anus functions and living quality of patients in the two groups. Besides, all patients in two groups received MRI examinations, and images were processed by a convolutional neural network (CNN) algorithm. The results showed that in MRI images, there were significant signal differences between lesion tissues and normal tissues. After being processed by an artificial intelligence algorithm, the definition of MRI images was remarkably enhanced with clearer lesion edges. The quality of images was also significantly improved. Besides, the comparison of anus functions of patients in two groups showed that the differences demonstrated statistical meaning after the intervention (P < 0.05). In conclusion, artificial intelligence algorithm-based MRI and comprehensive pelvic floor muscle exercise showed significant application prospects and values in the recovery of patients' intestinal functions after RC anus-preserving surgery.