Feasibility and acceptability of couple counselling and pelvic floor muscle training after operation for prostate cancer

Abstract

Background: Radical prostatectomy is often followed by long-lasting erectile dysfunction and urinary incontinence, with adverse effects on the quality of life and intimate relationship of patients and partners. We developed the ProCan intervention to ameliorate sexual and urological dysfunction after radical prostatectomy and examined its feasibility, acceptability and changes in sexual function. Material and methods: Between May 2014 and October 2014, seven couples attending the Department of Urology, Rigshospitalet, were included 3-4 weeks after radical prostatectomy in the ProCan intervention, which consists of up to six couple counselling sessions, group instruction in pelvic floor muscle training (PFMT), up to three individual PFMT sessions and a DVD home training program. We examined its feasibility on the basis of the recruitment rate, adherence to and acceptability of the intervention, the response rate and changes in erectile and sexual functioning measured on the International Index of Erectile Function at baseline and at eight and 12 months. Results: The recruitment rate was 14%. One couple withdrew, six couples attended 1-4 counselling sessions, and all patients attended PFMT until continence was achieved. The response rate on outcomes was 85% for patients and 71% for partners. The couples reported that counselling improved their sex life but it did not improve their ability to talk openly about sex. Most patients found that the physiotherapist improved their motivation and the quality and intensity of PFMT. Erectile dysfunction improved from severe at baseline to moderate at eight months' follow-up, and mean sexual functioning improved from 18.4 to 37.1 points at eight months' follow-up, but decreased slightly to 31.4 at 12 months. Conclusion: Our results suggest that the recruitment procedure should be adapted and minor revisions are needed in the intervention. The key components, couple counselling and PFMT, were well accepted and achievable for the patients.

One Thing at a Time… Timeliness of Rehabilitation for Sexual Problems in Men With Prostate Cancer

“…However, su cient study enrollment was not feasible, and the study was closed. This nding was in line with Karlsen et al, who had a recruitment rate as low as 14% in a population of prostate patients and partners offered sexual rehabilitation after prostatectomy (21). A more thorough pilot phase of the study might have resulted in critical knowledge and su cient redesign of the study.…”

“…No matter the best intentions of early intervention for this vulnerable group, we found it impossible to recruit the number of newly diagnosed patients with PC referred to radiotherapy and androgen deprivation therapy as planned. The inclusion rate of 38% was not lower than other randomised trials targeting sexual problems (20,21), but patients available in this single study site were too few according to the time frame and intervention planned. The inclusion period was de ned based on expectations of recruitment of at least four patients every month (Fig.…”

Whole body vibration exercise in the management of cancer therapy-related morbidities: A systematic review

“…The urinary incontinence is other morbidity that has been found after radical prostatectomy in prostate cancer patients (55). This dysfunction has noninvasive modalities considered first-line treatment during the first 6-12 months following prostatectomy and conservative modalities include pelvic floor muscle training (56).…”

Couple Counseling and Pelvic Floor Muscle Training for Men Operated for Prostate Cancer and for Their Female Partners: Results From the Randomized ProCan Trial

“… 20 , 21 , 22 Thus we had previously developed and pilot tested the ProCan intervention consisting of couple counseling and PFMT, which used elements from social cognitive theory 23 such as: active learning, adjustment of outcome expectations, modeling guided practice, and psychoeducation on urinary and sexual problems including the use of treatment for ED. 24 …”

“…[20][21][22] Thus we had previously developed and pilot tested the ProCan intervention consisting of couple counseling and PFMT, which used elements from social cognitive theory 23 such as: active learning, adjustment of outcome expectations, modeling guided practice, and psychoeducation on urinary and sexual problems including the use of treatment for ED. 24 The aim of this RCT was to test the effect of the ProCan intervention on sexual and urinary dysfunction after surgery for PC compared to usual treatment. We hypothesized, that early couple counseling and PFMT would significantly improve the primary outcome erectile function, and the secondary outcomes including sexual and urinary function and use of treatment for ED by patients; sexual function of female partners; and relationship function, health-related quality of life, anxiety, depression and self-efficacy in both patients and female partners.…”