Impact of early pelvic floor rehabilitation after transurethral resection of the prostate

Abstract

We examined the results of teaching pelvic floor muscle exercises (PME) on micturition parameters, urinary incontinence, post-micturition dribbling, and quality of life in patients after transurethral prostatectomy (TURP). Fifty-eight consecutive patients who were selected to undergo TURP for benign prostatic hyperplasia (BPH) were admitted into the study: 28 were randomly assigned to a control group (A), 30 formed the investigational group (B) during an initial visit conducted before surgery. In group B patients, perineal exercises were demonstrated in detail, and tested for their correct use via simultaneous rectal and abdominal examination. After the removal of the urethral catheter, these patients were instructed to perform pelvic floor muscle exercises at home and were evaluated before the exercises and at weekly intervals postoperatively. The American Urological Association Symptom Score improved significantly after TURP in both groups. The average quality of life score improved more significantly in group B after TURP, from 5.5 to 1.5 (P < 0.001). The grade of muscle contraction strength after 4 weeks of PME increased from 2.8 to 3.8 in group B (P < 0.01); it was unchanged in the group A. The number of patients with incontinence episodes and post-micturition dribbling was significantly lower in the group B at weeks 1, 2, and 3 (P < 0.01). Our results show that pelvic floor muscle re-education produces a quicker improvement of urinary symptoms and of quality of life in patients after TURP. Its early practice reduces urinary incontinence and post-micturition dribbling in the first postoperative weeks. The exercises are simple and easy to perform in the clinical setting and at home, and therefore should be recommended to all cooperative patients after TURP.

Efficacy of tolterodine in preventing urge incontinence immediately after prostatectomy

“…Previous studies showed that early pelvic floor rehabilitation after transurethral prostatectomy provides significantly better satisfaction with life [35,36]. In our study, the presence of urge incontinence postoperatively did not correlate with the QoL index in either group of our patients.…”

“…Pelvic floor muscle exercise is usually recommended for early postoperative micturition problems with satisfactory results [35,36]. The effectiveness of tolterodine in treating OAB symptoms as well as its tolerability have been established by a series of clinical studies [37][38][39][40][41][42][43][44][45][46].…”

Predictors of de novo urge urinary incontinence after photoselective vaporization of the prostate

“…To date, several studies have evaluated the efficacy of treatment measure including early pelvic floor muscle exercise (PFME) or anticholinergic medications to alleviate storage symptoms such as UUI and, thereby, improve QOL in the early postoperative period after TURP [12,[14][15][16]. The previous studies showed that early PFME, which was started immediately after removal of urethral catheter, reduced UUI in the first few weeks after TURP [12,14].…”

“…The previous studies showed that early PFME, which was started immediately after removal of urethral catheter, reduced UUI in the first few weeks after TURP [12,14]. Hou et al [15] reported that the group with immediate initiation of PFME had greater improvement in subtotal storage symptom score and QOL than control group at 12 weeks after TURP.…”

La rééducation de l’incontinence urinaire de l’homme

“…Un certain nombre d'études en ont étudié les indications et les résultats, certaines d'entre elles étant scientifiques, randomisées et avec groupe témoin, et d'autres relatant davantage une expérience et une étude de population [1][2][3][4][5][6][7][8][9][10][11][12][13].…”