Radikal Prostatektomi Sonrası Üriner İnkontinansın Düzelmesinde Pelvik Tabanda Biofeedback ve Elektrik Stimülasyonunun Etkisi

Abstract

Objective: Urinary incontinence (UI) is one of the most distressing postoperative problems of radical prostatectomy (RP) and negatively affects the quality of life (QOL). We assessed the effect of pelvic muscle exercises (PME), electrical stimulation (ES) and biofeedback (BFB) on UI after RP. Materials and Methods: 80 patients, who underwent RP, were randomized into three groups. Group I (n=26) received instructions about PME, group II (n=26) received ES and group III (n=28) received ES plus BFB. The treatment was started one week after catheter removal, twice a week for 12 weeks. The evaluation of continence was performed at time 0, 6, 12 weeks, and 24 weeks during follow-up, using the 24-hour pad test and the QOL using the incontinence impact questionnaire -7 (IIQ-7). Results: The mean leakage weight became significantly lower (p<0.05) in group III than in groups II and I starting at 6 weeks until 24 weeks of follow-up. A significant difference (p<0.05) between the groups in terms of percentage of continent patients was achieved from 12 weeks (71.42%, 53.85% and 34.62%) to 24 weeks (96.43%, 76.92% and 65.38%) for groups III, II and I, respectively. Conclusion: Early, noninvasive therapy with ES and BFB has a significant positive effect on the duration and the degree of UI and QOL. Turk J Phys Med Re hab 2012;58:170-6. Key Words: Urinary incontinence; radical prostatectomy; electrical stimulation; biofeedback Özet Amaç: Üriner inkontinans (Üİ) radikal prostatektominin (RP) en sıkıntı verici ameliyat sonrası komplikasyonlarından olup, yaşam kalitesini (YK) olumsuz etkiler. Bu çalışmada pelvik kas egzersizleri (PKE), elektrik stimülasyonu (ES) ve biofeedback (BFB) uygulamasının RP sonrası Üİ üzerindeki etkisini araştırdık. Gereç ve Yöntem: RP geçirmiş 80 hasta üç gruba randomize edildi. Grup I e (n=26) PKE, Grup II'ye (n=26) ES ve Grup III'e (n=28) ES artı BFB verildi. Kateterin çıkarılmasından bir hafta sonra başlanan tedavi on iki hafta boyunca haftada iki gün uygulandı. 0, 6, 12 ve 24. haftalardaki takip sırasında kontinans 24 saatlik ped testi ile yaşam kalitesi ise inkontinans etki anketi-7 (IIQ-7) ile değerlendirilmiştir. Bulgular: Grup I de, altıncı haftadan başlayarak 24 üncü hafta takiplerine kadar görülen ortalama sızıntı miktarı Grup I ve II ye göre önemli ölçüde daha azdı. Gruplarda kontinans oranı bakımından 12. haftada (Grup III, II ve I için sırasıyla %71,42, %53,85 ve %34,62) ve 24 üncü haftada (%94,43, %76,92 ve %65,38) önemli farklara ulaşıldı. Sonuç: ES ve BFB ile erken noninvaziv terapinin Üİ süresi ve derecesi ile YK üzerinde önemli bir etkisi bulunmaktadır. Türk Fiz T›p Re hab Derg

Physiotherapy as an Effective Method to Support the Treatment of Male Urinary Incontinence: A Systematic Review

“…In most of the analyzed research protocols, electrostimulation was combined with other PFM therapeutic techniques [ 16 , 27 , 30 , 33 , 40 , 48 , 52 ] and lasted between 15 [ 16 , 31 , 40 , 52 ] and 20 min [ 27 , 33 , 34 ]. Ahmed et al [ 16 ] observed that UI therapy outcomes may improve after combining ES therapy with BF [ 16 ].…”

“…In most of the analyzed research protocols, electrostimulation was combined with other PFM therapeutic techniques [ 16 , 27 , 30 , 33 , 40 , 48 , 52 ] and lasted between 15 [ 16 , 31 , 40 , 52 ] and 20 min [ 27 , 33 , 34 ]. Ahmed et al [ 16 ] observed that UI therapy outcomes may improve after combining ES therapy with BF [ 16 ]. Mariotti et al [ 33 ] confirmed these findings in the early therapy of men after prostate surgery, with significant continence improvements appearing between the 4 week and 6 month follow-ups [ 33 ].…”

“…BF can also be combined with PFMT [ 16 , 19 , 21 , 35 , 41 , 46 ]. Studies have indicated that BF-assisted training can improve short-term and long-term continence more effectively than PFMT alone [ 67 ].…”

“… RoB analysis ( n = 55). Low risk studies: [ 16 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 35 , 36 , 37 , 39 , 40 , 41 , 42 , 43 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ], some concerns studies: [ 17 , 18 , 34 , 38 , 44 , 54 ], high risk studies [ 62 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , …”

Non‐pharmacological and nonsurgical interventions in male urinary incontinence: A scoping review

“…The additional benefits brought by ES on a basis of PFMT appeared conflicting owing to five positive results (Ahmed et al, 2012; Mariotti et al, 2009; Nakagawa et al, 2010; Soto Gonzalez et al, 2020; Yamanishi et al, 2010) and five negative results (Goode et al, 2011; Laurienzo et al, 2013, 2018; Moore et al, 1999; Wille et al, 2003). The main reason maybe the parameters of ES and site of stimulation differed greatly among the included studies.…”