Improvement of Urinary Incontinence, Life Impact, and Depression and
Anxiety With Modified Pelvic Floor Muscle Training After Radical
Prostatectomy

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Abstract

Prostate cancer ranks second among male cancers in the United States in terms of death rate. Robot-assisted surgery (RAS) is now offered as the standard surgical procedure performed for radical prostatectomy. Urinary incontinence and erectile dysfunction were common complications after RAS prostatectomy. Patients felt ill-prepared after surgery, resulting in negative impacts on their quality of life. Pelvic floor muscle exercise is prioritized for patients with mild-to-moderate incontinence. The purpose of this study was to examine the effects of using resistance band pelvic floor muscle exercise for patients after RAS prostatectomy. A preexperimental single-group study was conducted for this study. A total of 43 patients completed the program. Urinary incontinence scale, Incontinence Impact Questionnaire, and Hospital Anxiety and Depression Scale were assessed at 0.5 months, 1 month, 2 months, and 3 months after urinary catheter removal. The results revealed that urinary incontinence, life impact, and depression and anxiety improved significantly as time went on. This study suggests that using simple and easy-to-learn resistance band pelvic floor muscle exercise program at home can benefit patients financially and reduce travel time.

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Most cited references 15

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An alternative intervention for urinary incontinence: retraining diaphragmatic, deep abdominal and pelvic floor muscle coordinated function.

Hsiu-Chuan Hung, Sheng-Mou Hsiao, Shu-Yun Chih … (2010)

This study was a randomized controlled trial to investigate the effect of treating women with stress or mixed urinary incontinence (SUI or MUI) by diaphragmatic, deep abdominal and pelvic floor muscle (PFM) retraining. Seventy women were randomly allocated to the training (n = 35) or control group (n = 35). Women in the training group received 8 individual clinical visits and followed a specific exercise program. Women in the control group performed self-monitored PFM exercises at home. The primary outcome measure was self-reported improvement. Secondary outcome measures were 20-min pad test, 3-day voiding diary, maximal vaginal squeeze pressure, holding time and quality of life. After a 4-month intervention period, more participants in the training group reported that they were cured or improved (p < 0.01). The cure/improved rate was above 90%. Both amount of leakage and number of leaks were significantly lower in the training group (p < 0.05) but not in the control group. More aspects of quality of life improved significantly in the training group than in the control group. Maximal vaginal squeeze pressure, however, decreased slightly in both groups. Coordinated retraining diaphragmatic, deep abdominal and PFM function could improve symptoms and quality of life. It may be an alternative management for women with SUI or MUI.

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The Effect of Pelvic Floor Muscle Training On Incontinence Problems After Radical Prostatectomy

Aylin Aydın Sayılan, Ayfer Ozbaş (2018)

The aim of the current study was to determine the effect of pelvic floor muscle exercises (PFME/Kegel) training administered to patients scheduled for robot-assisted radical prostatectomy on postprocedural incontinence problems. This study was a randomized controlled trial. Pelvic floor muscle exercises were applied to the procedure group three times a day for 6 months. No exercises were applied to the control group. Incontinence and quality-of-life assessments of the 60 patients in the experimental and control groups were performed on months 0 (10 days after removal of the urinary catheter), 1, 3, and 6 through face-to-face and telephone interviews. Total Incontinence Consultation on Incontinence-Short Form scores, which provide an objective criterion for the evaluation of individuals with incontinence problems, decreased over time. This decrease was statistically highly significant in the third and sixth months. Pelvic muscle floor exercises are suitable for patients experiencing incontinence after radical prostatectomy.

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Conservative treatment for urinary incontinence in Men After Prostate Surgery (MAPS): two parallel randomised controlled trials.

L Vale, C Boachie, J N'Dow … (2011)

To determine the clinical effectiveness and cost-effectiveness of active conservative treatment, compared with standard management, in regaining urinary continence at 12 months in men with urinary incontinence at 6 weeks after a radical prostatectomy or a transurethral resection of the prostate (TURP). Urinary incontinence after radical prostate surgery is common immediately after surgery, although the chance of incontinence is less after TURP than following radical prostatectomy. Two multicentre, UK, parallel randomised controlled trials (RCTs) comparing active conservative treatment [pelvic floor muscle training (PFMT) delivered by a specialist continence physiotherapist or a specialist continence nurse] with standard management in men after radial prostatectomy and TURP. Men having prostate surgery were identified in 34 centres across the UK. If they had urinary incontinence, they were invited to enroll in the RCT. Men with urinary incontinence at 6 weeks after prostate surgery were eligible to be randomised if they consented and were able to comply with the intervention. Eligible men were randomised to attend four sessions with a therapist over a 3-month period. The therapists provided standardised PFMT and bladder training for male urinary incontinence and erectile dysfunction. The control group continued with standard management. The primary outcome of clinical effectiveness was urinary incontinence at 12 months after randomisation, and the primary measure of cost-effectiveness was incremental cost per quality-adjusted life-year (QALY). Outcome data were collected by postal questionnaires at 3, 6, 9 and 12 months. Within the radical group (n = 411), 92% of the men in the intervention group attended at least one therapy visit and were more likely than those in the control group to be carrying out any PFMT at 12 months {adjusted risk ratio (RR) 1.30 [95% confidence interval (CI) 1.09 to 1.53]}. The absolute risk difference in urinary incontinence rates at 12 months between the intervention (75.5%) and control (77.4%) groups was -1.9% (95% CI -10% to 6%). NHS costs were higher in the intervention group [£ 181.02 (95% CI £ 107 to £ 255)] but there was no evidence of a difference in societal costs, and QALYs were virtually identical for both groups. Within the TURP group (n = 442), over 85% of men in the intervention group attended at least one therapy visit and were more likely to be carrying out any PFMT at 12 months after randomisation [adjusted RR 3.20 (95% CI 2.37 to 4.32)]. The absolute risk difference in urinary incontinence rates at 12 months between the intervention (64.9%) and control (61.5%) groups for the unadjusted intention-to-treat analysis was 3.4% (95% CI -6% to 13%). NHS costs [£ 209 (95% CI £ 147 to £ 271)] and societal costs [£ 420 (95% CI £ 54 to £ 785)] were statistically significantly higher in the intervention group but QALYs were virtually identical. The provision of one-to-one conservative physical therapy for men with urinary incontinence after prostate surgery is unlikely to be effective or cost-effective compared with standard care that includes the provision of information about conducting PFMT. Future work should include research into the value of different surgical options in controlling urinary incontinence.

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Author and article information

Journal

Journal ID (nlm-ta): Am J Mens Health

Journal ID (iso-abbrev): Am J Mens Health

Journal ID (publisher-id): JMH

Journal ID (hwp): spjmh

Title: American Journal of Men's Health

Publisher: SAGE Publications (Sage CA: Los Angeles, CA )

ISSN (Print): 1557-9883

ISSN (Electronic): 1557-9891

Publication date (Electronic): 15 May 2019

Publication date Collection: May-Jun 2019

Volume: 13

Issue: 3

Electronic Location Identifier: 1557988319851618

Affiliations

[1 ]Department of Nursing, Chang Gung Memorial Hospital, Linkou

[2 ]Division of Urology Surgery, Chang Gung Memorial Hospital, Linkou

[3 ]School of Nursing, Chang Gung University of Science and Technology, Taoyuan City

[4 ]Graduate Institute of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan City

Author notes

[*]Whe-Mei Shih RN, PhD, Associate Professor, Graduate Institute of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan City and Chang Gung Memorial Hospital, Linkou. Email: jeanshih168@ 123456frontier.com

Author information

Li-Hui Pan https://orcid.org/0000-0001-5262-4163

Article

Publisher ID: 10.1177_1557988319851618

DOI: 10.1177/1557988319851618

PMC ID: 6537297

PubMed ID: 31092098

SO-VID: f20ebd7c-84f9-4b99-8272-61cdf75835f2

License:

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Date received : 8 January 2019

Date revision received : 9 April 2019

Date accepted : 14 April 2019

Funding

Funded by: Chang Gung Memorial Hospital, Linkou, FundRef https://doi.org/10.13039/501100005795;

Award ID: CMRPG3B0621

Custom metadata

cover-date May-June 2019

Keywords: men’s health programs,health-care issues,prostate cancer,oncology/cancer,prostatectomy

Data availability:

Keywords: men’s health programs, health-care issues, prostate cancer, oncology/cancer, prostatectomy

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Improvement of Urinary Incontinence, Life Impact, and Depression and Anxiety With Modified Pelvic Floor Muscle Training After Radical Prostatectomy

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Most cited references 15

An alternative intervention for urinary incontinence: retraining diaphragmatic, deep abdominal and pelvic floor muscle coordinated function.

The Effect of Pelvic Floor Muscle Training On Incontinence Problems After Radical Prostatectomy

Conservative treatment for urinary incontinence in Men After Prostate Surgery (MAPS): two parallel randomised controlled trials.

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