Does trunk muscle training with an oscillating rod improve urinary incontinence after radical prostatectomy? A prospective randomized controlled trial

Abstract

Objective: To investigate the effect of a new therapeutic approach, using an oscillating rod to strength the pelvic floor and deep abdominal musculature and to speed up recovery of continence after radical prostatectomy. Design: Prospective randomized controlled clinical trial. Setting: Inpatient uro-oncology rehabilitation clinic. Subjects: Ninety-three (intervention group (IG)) and ninety-one patients (control group (CG)) with urinary incontinence after prostatectomy were examined. Intervention: All patients were randomly allocated to either standard pelvic floor muscle exercises and oscillating rod therapy (IG) or standard pelvic floor muscle exercises and relaxation therapy (CG). Main outcome measures: Urinary incontinence (1- and 24-hour pad test) was assessed, and health-related quality of life (HRQL; Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire) was measured for all patients before and after three weeks of treatment. Results: One hundred and eighty-four patients (mean (SD) age: 64.1 (6.94) years) completed the study. The IG showed a significant reduction in urinary incontinence (1-hour pad test: P = 0.008, 24-hour pad test: P = 0.012) and a significant improvement of HRQL ( P = 0.017) compared with CG. Continence was significantly improved in both groups (1-hour pad test: 22.6–8.5 g (IG) vs. 23.0–18.1 g (CG)/24-hour pad test: 242.9–126.7 g (IG) vs. 237.6–180.9 g (CG)). Conclusion: The study demonstrated that a combination of conventional continence exercises and the new oscillation rod training increased abdominal and pelvic floor musculature and speeded up recovery of continence after radical prostatectomy.

Analysis of conventional versus advanced pelvic floor muscle training in the management of urinary incontinence after radical prostatectomy: a systematic review and meta-analysis of randomized controlled trials

“…They found a moderate inverse correlation has been identified between muscle power and 24-hour pad test in APFMT (14). Subsequently, several trials published their findings of APFMT compared to CPFMT (15)(16)(17)(18). Our study indicated that APFMT and CPFMT were feasible owing to low attrition rate and no adverse events reported.…”

“…No adverse events were reported in all included studies (13)(14)(15)(16)(17)(18). Patients receiving APFMT had a similar attrition rate to those receiving CPFMT (18/236 vs. 22/282, P=0.61).…”

“…Figure 1 presents the RoB summary of the six RCTs (13)(14)(15)(16)(17)(18). Taken together, included studies showed a low risk of bias in terms of selection, performance, detection, attrition and reporting.…”

“…For pad weight, meta-analysis of two studies (15,17) with 122 participants receiving postoperative CPFMT found a significant improvement within one month after surgery (MD: -28.95, 95% CI: -32.12 to -25.77; P<0.00001), and there is a tendency to improve at short-term (13,15) and intermediate-term follow-up (14,16). Data from one small study (13, n=28) identified a less number of pads per day at 10 weeks post-intervention (0.82 vs. 2.75), and the overall effect was significant (-1.93, 95% CI: -2.56 to -1.30; P<0.00001).…”

“…Pooled analysis of two studies (14,16) showed a significantly longer duration of PFME in APFMT group (MD: 1.93, 95% CI: 0.99 to 2.87; P<0.0001) than their counterpart; however, there was no significant difference between these two groups in terms of PFMS (P=0.48). For pad weight, meta-analyses of two studies (15,17) and another two studies (14,18) indicated significant superiority of APFMT over CPFMT withing 1 month after surgery (MD: -17.10, 95% CI: -20.39 to -13.81; P<0.00001) and at 3-to 6-month follow-up (MD: -1.40, 95% CI: -1.70 to -1.00; P<0.00001), respectively. However, data from three studies (13,15,18) detected no significant difference between APFMT group and CPFMT group at 1-to 3-month follow-up (P=0.86), and pooled analysis of two studies (16,18) also observed no significant difference between these two interventions at greater than 6-month follow-up (P=0.35).…”