PD24-04 PREOPERATIVE PELVIC FLOOR MUSCLE EXERCISE FOR EARLY CONTINENCE AFTER HOLMIUM LASER ENUCLEATION OF THE PROSTATE: A RANDOMIZED CONTROLLED STUDY

Abstract Background: Transient postoperative urinary incontinence is a bothersome complication of holmium laser enucleation of the prostate (HoLEP). The effects of preoperative pelvic floor muscle exercise (PFME) for early recovery of continence after HoLEP have never been elucidated. The aim of this study was to determine the benefit of preoperatively started pelvic PFME for early continence recovery after HoLEP. Methods: We randomly assigned patients to start PFME preoperatively and continue postoperatively (group A) or start PFME no earlier than the postoperative period (group B). The primary outcome was time to complete urinary control, defined as no pad usage. The secondary quality of life measure was determined via International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) scores. Univariate and multivariate analyses were performed to identify parameters associated with recovery of urinary continence after HoLEP. Results: Seventy patients were randomized across groups A (n = 35) and B (n = 35). Patients’ characteristics were not different between groups A and B. The postoperative urinary incontinence rate significantly decreased in group A compared with that in group B at 3 months postoperatively [3% vs. 26% (P = 0.01)]. However, there were no significant differences between groups A and B at 3 days [40% vs. 54% (P = 0.34)], 1 month [37% vs. 51% (P = 0.34)], and 6 months [0% vs. 3% (P = 1.00)] postoperatively, respectively. The postoperative ICIQ-SF scores were not significantly different between groups A and B at any time point postoperatively. In logistic regression analysis, patients who performed preoperative PFME had a 0.56-fold lower risk of urinary incontinence 1 month after HoLEP and a 0.08-fold lower risk of urinary incontinence 3 months after HoLEP. Conclusions: Preoperatively started PFME appears to facilitate early improvement of urinary incontinence after HoLEP. Keywords: Benign Prostatic Hyperplasia, Incontinence, HoLEP, Pelvic Floor Muscle Exercise Trial registration: The study was registered with the University Hospital Medical Information Network Clinical Trials Registry in Japan (UMIN000034713); registration date: 31 October 2018. Retrospectively registered

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Preoperative pelvic floor muscle exercise for early continence after holmium laser enucleation of the prostate: a randomized controlled study

10.21203/rs.2.14791/v1 ◽

2019 ◽

Author(s):

Go Anan ◽

Yasuhiro Kaiho ◽

Hiromichi Iwamura ◽

Jun Ito ◽

Yuki Kohada ◽

...

Keyword(s):

Urinary Incontinence ◽

Pelvic Floor ◽

Lower Risk ◽

Pelvic Floor Muscle ◽

Muscle Exercise ◽

Pelvic Floor Muscle Exercise ◽

Group A ◽

Laser Enucleation ◽

Group B ◽

Holmium Laser Enucleation

Abstract Background: Transient postoperative urinary incontinence is a bothersome complication of holmium laser enucleation of the prostate (HoLEP). The effects of preoperative pelvic floor muscle exercise (PFME) for early recovery of continence after HoLEP have never been elucidated. The aim of this study was to determine the benefit of preoperatively started pelvic PFME for early continence recovery after HoLEP. Methods: We randomly assigned patients to start PFME preoperatively and continue postoperatively (group A) or start PFME no earlier than the postoperative period (group B). The primary outcome was time to complete urinary control, defined as no pad usage. The secondary quality of life measure was determined via International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) scores. Univariate and multivariate analyses were performed to identify parameters associated with recovery of urinary continence after HoLEP. Results: Seventy patients were randomized across groups A (n = 35) and B (n = 35). Patients’ characteristics were not different between groups A and B. The postoperative incontinence rate significantly decreased in group A compared with group B at 3 months postoperatively [3% vs. 26% (P = 0.01)]. However, there were no significant differences between groups A and B at 3 days [40% vs. 54% (P = 0.34)], 1 month [37% vs. 51% (P = 0.34)], and 6 months [0% vs. 3% (P = 1.00)] postoperatively, respectively. The postoperative ICIQ-SF scores were not significantly different between groups A and B at any time point postoperatively. In logistic regression analysis, patients who performed preoperative PFME had a 0.56-fold lower risk of incontinence 1 month after HoLEP and a 0.08-fold lower risk of incontinence 3 months after HoLEP. Conclusions: Preoperatively started PFME appears to facilitate early improvement of urinary incontinence after HoLEP.

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GreenLight™ Laser (XPS) Photoselective Vapo-Enucleation versus Holmium Laser Enucleation of the Prostate for the Treatment of Symptomatic Benign Prostatic Hyperplasia: A Randomized Controlled Study

The Journal of Urology ◽

10.1016/j.juro.2014.09.097 ◽

2015 ◽

Vol 193 (3) ◽

pp. 927-934 ◽

Cited By ~ 55

Author(s):

Ahmed M. Elshal ◽

Mohamed A. Elkoushy ◽

Ahmed R. El-Nahas ◽

Ahmed M. Shoma ◽

Adel Nabeeh ◽

...

Keyword(s):

Benign Prostatic Hyperplasia ◽

Prostatic Hyperplasia ◽

Holmium Laser ◽

Randomized Controlled Study ◽

Controlled Study ◽

Symptomatic Benign Prostatic Hyperplasia ◽

Randomized Controlled ◽

Laser Enucleation ◽

Holmium Laser Enucleation

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Preoperative pelvic floor muscle exercise for early continence after holmium laser enucleation of the prostate: a randomized controlled study

10.21203/rs.2.14791/v2 ◽

2019 ◽

Author(s):

Go Anan ◽

Yasuhiro Kaiho ◽

Hiromichi Iwamura ◽

Jun Ito ◽

Yuki Kohada ◽

...

Keyword(s):

Urinary Incontinence ◽

Pelvic Floor ◽

Lower Risk ◽

Pelvic Floor Muscle ◽

Muscle Exercise ◽

Pelvic Floor Muscle Exercise ◽

Group A ◽

Laser Enucleation ◽

Group B ◽

Holmium Laser Enucleation

Abstract Background: Transient postoperative urinary incontinence is a bothersome complication of holmium laser enucleation of the prostate (HoLEP). The effects of preoperative pelvic floor muscle exercise (PFME) for early recovery of continence after HoLEP have never been elucidated. The aim of this study was to determine the benefit of preoperatively started pelvic PFME for early continence recovery after HoLEP. Methods: We randomly assigned patients to start PFME preoperatively and continue postoperatively (group A) or start PFME no earlier than the postoperative period (group B). The primary outcome was time to complete urinary control, defined as no pad usage. The secondary quality of life measure was determined via International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) scores. Univariate and multivariate analyses were performed to identify parameters associated with recovery of urinary continence after HoLEP. Results: Seventy patients were randomized across groups A (n = 35) and B (n = 35). Patients’ characteristics were not different between groups A and B. The postoperative incontinence rate significantly decreased in group A compared with group B at 3 months postoperatively [3% vs. 26% (P = 0.01)]. However, there were no significant differences between groups A and B at 3 days [40% vs. 54% (P = 0.34)], 1 month [37% vs. 51% (P = 0.34)], and 6 months [0% vs. 3% (P = 1.00)] postoperatively, respectively. The postoperative ICIQ-SF scores were not significantly different between groups A and B at any time point postoperatively. In logistic regression analysis, patients who performed preoperative PFME had a 0.56-fold lower risk of incontinence 1 month after HoLEP and a 0.08-fold lower risk of incontinence 3 months after HoLEP. Conclusions: Preoperatively started PFME appears to facilitate early improvement of urinary incontinence after HoLEP.

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