Pelvic floor muscle training and electrical stimulation as rehabilitation after radical prostatectomy: a randomized controlled trial

Abstract

[Purpose] To investigate the effect of electrical stimulation and pelvic floor muscle training on muscle strength, urinary incontinence and erectile function in men with prostate cancer treated by radical prostatectomy. [Subjects and Methods] One hundred twenty-three males were randomized into 3 groups 1 month after RP: (G1, n=40) control; (G2, n=41) guideline: patients were instructed to perform three types of home exercises to strengthen the pelvic floor and (G3, n=42) electrical stimulation: patients in this group were also instructed to perform exercises as group G2, and also received anal electro-stimulation therapy, twice a week for 7 weeks. The primary outcome assessment was based on the measurement of the recovery of pelvic floor muscle strength between groups. Secondary outcomes were: 1 hour Pad Test, ICIQ-SF, IIEF-5 and IPSS. Data were obtained preoperatively and at 1, 3 and 6 months after surgery. [Results] There was no significant difference in the demographic data among groups. Greater urinary leakage and pelvic floor muscle weakness in the first month compared to pre treatment improved after 3 and 6 months postoperative, without difference among groups. [Conclusion] The muscle strength recovery occurs independently of the therapy employed. Pelvic floor exercises or electrical stimulation also did not have an impact on the recovery of urinary continence and erectile function in our study.

Do features of randomized controlled trials of pelvic floor muscle training for postprostatectomy urinary incontinence differentiate successful from unsuccessful patient outcomes? A systematic review with a series of meta‐analyses

“…The definition of continence varied between studies and depended on the method of evaluation of urine loss: 1‐hour pad test, 21,30,33,35,37 24‐hour pad test, 32,33,36–40 International Consultation of Incontinence Questionnaire–Urinary Incontinence (ICIQ‐UI), 29,41,42 bladder diary, 22,34,43 and number of pads/day 44–49 . Irrespective of the outcome measure, continence was defined as no leakage in 44% (n = 4) and 46% (n = 6) of efficacious and not efficacious studies, respectively (Table 3).…”

“…After removal of duplicates and exclusion of ineligible studies, 22 manuscripts fulfilled the eligibility criteria (Figure 1). Two additional studies 29,30 were included from the updated search.…”

“…The most common time point for data collection was at 3 months. Seven studies did not provide data for incontinence rate at 3 months and were unable to be included in the meta‐analysis 21,30,32–36 …”

“…After removal of duplicates and exclusion of ineligible studies, 22 manuscripts fulfilled the eligibility criteria ( Figure 1). Two additional studies 29,30 were included from the updated search. Authors of 17 studies were contacted to obtain more detailed information and eight responded to the request.…”

Função dos músculos do assoalho pélvico após o tratamento do câncer de próstata: um estudo transversal

“…Dessa forma, não há padronização de melhor técnica para sua avaliação. Porém, nos estudos realizados e na prática clínica, os recursos comumente utilizados são: palpação digital anal, perineometria, eletromiografia de superfície (EMG) e métodos de imagens, como a ultrassonografia e a ressonância magnética (LAURIENZO et al, 2018;MANLEY et al, 2016, HACAD et al, 2015SOHN, 2013).…”