scholarly journals How to Predict Outcomes from a Biofeedback and Pelvic Floor Muscle Electric Stimulation Program in Patients with Urinary Incontinence after Radical Prostatectomy

2021 ◽  
Vol 11 (1) ◽  
pp. 127
Author(s):  
Stefano Salciccia ◽  
Alessandro Sciarra ◽  
Martina Moriconi ◽  
Martina Maggi ◽  
Pietro Viscuso ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Radical Prostatectomy ◽  
Pelvic Floor ◽  
Electric Stimulation ◽  
Pelvic Floor Muscle ◽  
Prospective Trial ◽  
Rehabilitation Program ◽  
Primary Objective ◽  
Pelvic Floor Rehabilitation ◽  
Free Status

Objectives: The objective of this study was to analyze the pre-operative and intra-operative variables that can condition urinary incontinence (UI) after radical prostatectomy (RP), as well as continence rate recovery during a pelvic floor rehabilitation program. Materials and Methods: A total of 72 cases with UI after RP were prospectively examined. All cases were homogeneously treated by the same surgeon, using the same RP technique. A combination of biofeedback (BF) and pelvic floor electric stimulation (PFES) performed by the same clinician and using the same protocol was used. Clinical, pathologic and surgical variables were analyzed in terms of 24 h pad test results (pad weight and pad-free status). Results: Prostate volume (PV) strongly varied from 24 to 127 cc (mean ± SD 46.39 ± 18.65 cc), and the baseline pad weight varied from 10 to 1500 cc (mean ± SD 354.29 ± 404.15 cc). PV strongly and positively correlated with the baseline pad weight (r = 0.4215; p = 0.0269) and inversely with the three-month pad weight (r = − 0.4763; p = 0.0213) and pad-free status (r =− 0.3010; p = 0.0429). The risk of a residual pad weight >10 g after the rehabilitative program significantly increased according to PV (p = 0.001) and the baseline pad weight (p = 0.002 and < 0.0001). In particular, PV > 40 cc and a baseline pad weight >400 g significantly (p = 0.010 and p < 0.0001, respectively) and independently predicted a 5.7 and a 35.4 times increase in the risk of a residual pad weight at the three-month follow-up, respectively. Conclusion: This is the first prospective trial whose primary objective is to verify the possible predictors, such as PV, that are able to condition the response to a pelvic floor rehabilitation program for UI after RP.

Dynamics of pelvic floor muscle functional parameters and their correlations with urinary incontinence in men after radical prostatectomy

2015 ◽  
Vol 36 (1) ◽  
pp. 126-131 ◽  
Author(s):  
Brigita Zachovajevienė ◽  
Laimonas Šiupšinskas ◽  
Pavelas Zachovajevas ◽  
Daimantas Milonas
Keyword(s):  
Urinary Incontinence ◽  
Radical Prostatectomy ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Functional Parameters

scholarly journals Biofeedback-assisted pelvic floor muscle training in patients with urinary incontinence after laparoscopic and robot-assisted radical prostatectomy

2018 ◽  
Vol 14 (2) ◽  
pp. 102-108
Author(s):  
A. Z. Vinarov ◽  
L. M. Rapoport ◽  
G. E. Krupinov ◽  
Yu. L. Demidko ◽  
D. G. Tsarichenko ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Radical Prostatectomy ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle Training ◽  
Pelvic Floor Muscle ◽  
Muscle Contractions ◽  
Muscle Training ◽  
Robot Assisted ◽  
Pelvic Floor Muscle Exercises ◽  
Significant Difference

Background. Pelvic floor muscle exercises are used as a first-line treatment for urinary incontinence after radical prostatectomy. Their efficacy is still being investigated. The use of biofeedback when teaching pelvic floor muscle exercises to patients increases the effectiveness of therapy.Objective: to assess the efficacy of biofeedback-assisted pelvic floor muscle training in patients with urinary incontinence after laparoscopic and robot-assisted radical prostatectomy and to compare the results of teaching.Materials and methods. A total of 64 patients with urinary incontinence after nerve sparing prostatectomy underwent biofeedback-assisted pelvic floor muscle rehabilitation. Radical laparoscopic surgery was performed in 48 (75 %) patients, whereas robot-assisted surgery was performed in 16 (25 %) patients. The patients started their training 2 months postoperatively. We used two-channel electromyography with the Neurotrack ETS system (United Kingdom) to teach the patients isolated pelvic floor muscle contractions. After achieving a minimum activity of abdominal muscles during pelvic floor muscle contractions, the patients started exercises.Results. There was no significant difference in age between patients who underwent laparoscopic and robot-assisted radical prostatectomy (р = 0.79). Fifty-five patients (85.9%) acquired the skill of isolated pelvic floor muscle contractions and could perform training on their own. The remaining 9 patients (14.1 %) required regular support from healthcare professionals at an outpatient unit (1–2 biofeedback-assisted trainings per month). Thus, the type of surgery did not affect the process of training. The type of radical prostatectomy had no impact on the acquisition of the pelvic floor muscle contraction skill.Conclusion. The time for restoration of urinary continence by biofeedback-assisted pelvic floor muscle training did not vary between patients after laparoscopic and robot-assisted radical prostatectomy.

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