Early biofeedback-pelvic floor muscle training not only hastens the recovery of urinary continence after radical prostatectomy but allows for significant improvements in the severity of incontinence, voiding symptoms and pelvic floor muscle strength 12 months postoperatively.

Erectile dysfunction (ED) and urinary incontinence are common complications following radical prostatectomy (RP). Although pelvic-floor biofeedback training (PFBT) may improve urinary continence following RP, its effects on the recovery of potency are unknown. Fifty-two patients selected for RP were prospectively randomized for a treatment group (n ¼ 26) receiving PFBT once a week for 3 months and home exercises or a control group (n ¼ 26), in which patients received verbal instructions to contract the pelvic floor. Erectile function (EF) was evaluated with the International Index of Erectile Function-5 (IIEF-5) before surgery and 1, 3, 6 and 12 months postoperatively. Patients were considered potent when they had a total IIEF-5 score 420. Continence status was assessed and defined as the use of no pads. Groups were comparable in terms of age, body mass index, diabetes, pathological tumor stage and neurovascular bundle preservation. A significant reduction in IIEF-5 scores was observed after surgery in both groups. In the treatment group, 8 (47.1%) patients recovered potency 12 months postoperatively, as opposed to 2 (12.5%) in the control group (P ¼ 0.032). The absolute risk reduction was 34.6% (95% confidence interval (CI): 3.8--64%) and the number needed to treat was 3 (95% CI: 1.5--17.2). A strong association between recovery of potency and urinary continence was observed, with continent patients having a 5.4 higher chance of being potent (P ¼ 0.04). Early PFBT appears to have a significant impact on the recovery of EF after RP. Urinary continence status was a good indicator of EF recovery, with continent patients having a higher chance of being potent. 1 The most common long-term complications after prostatectomy (RP) are urinary incontinence and erectile dysfunction (ED).2 ED is estimated to affect 26--100% of patients after surgery. 3,4 The main cause of ED after RP is neurogenic, because of intraoperative injury to the neurovascular bundle.

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Background Electromyography (EMG) biofeedback has been used in spinal cord injury rehabilitation, but optimal indication and treatment protocols still need to be identified. Objectives To use an operant conditioning learning paradigm to compare the EMG responses in subjects with spinal cord injury for optimal indication of EMG biofeedback treatment. Participants Thirty rehabilitation outpatients with incomplete cervical spinal cord injury. The subjects were divided into three groups based on their scores on the ASIA scale (ASIA B, ASIA C and ASIA D groups), with ten patients in each group. Methods Repeated-measure trials were conducted to compare patients' EMG responses between pre-initial and post-biofeedback treatment. In the sessions, visual feedback of EMG activity of the triceps brachii muscle was provided to the patient in accordance with the treatment protocol. Results One-way ANOVA and the Kruskal-Wallis test were used to examine the differences in the measures between groups. The initial EMG and final EMG measures were not significantly different between the ASIA C and D groups, but these measures were different between the ASIA B group and the ASIA C and D groups. In the ASIA B group, the EMG responses started out lower than those in the other groups and varied less, especially in comparison to the ASIA C group. Conclusion: These results reveal that the patients classified as ASIA C and D achieved better responses of the operant conditional learning protocol and optimal indication for the biofeedback treatment.