Reducing Urine Leakage After Radical Retropubic Prostatectomy: Pelvic Floor Exercises, Magnetic Innervation or No Treatment? A Quasi-Experimental Study

Terzoni, Stefano; Montanari, Emanuele; Mora, Cristina; Ricci, Cristian; Destrebecq, Anne

doi:10.1002/rnj.72

Cited by 20 publications

(27 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the European guidelines, Kegel's exercises (sometimes referred to as PFMT, Pelvic Floor Muscle Training) are supported by grade A recommendations (Lucas et al , ) although the available studies include patients with considerably different clinical inclusion criteria, undergoing different operations. Some authors (Terzoni et al , ) have shown that PFMT has a beneficial impact on patient's ability to hold urine, if compared to the outcomes of patients who refused rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Developing a rehabilitation programme for male urinary incontinence: detailed schemes and results on 122 patients

Terzoni

Montanari

Mora

et al. 2015

Int J of Uro Nursing

Self Cite

View full text Add to dashboard Cite

Urinary incontinence (UI) is a common complication of prostatectomy. International guidelines suggest using pelvic floor muscle training (PFMT) as a first‐line intervention (grade A) to help patients reduce the involuntary urine leakages. In the literature it is hard to find a complete exercise scheme, with full details (e.g. body position during PFMT, how to avoid antagonist synergies), information on how to make exercises progressively more difficult, and data showing the efficacy of the whole programme. This study presents a complete PFMT programme, with full details and outcomes. A scheme of five progressive exercises was built, each with precise characteristics and times. Totally 131 patients with stress UI after radical retropubic prostatectomy were enrolled and followed a written scheme of PFMT with the five exercises. Leakages were quantified using the 24‐h pad test. Rehabilitation ended when patients had leakages less than 10 g/d. Nine patients could not achieve results and decided to exit the programme after a median of five sessions (InterQuartile Range, IQR = [4;7]). Out of the 122 patients, 90 patients who followed the full programme achieved the rehabilitation (70.3%); they had median leakages of 150 g, IQR = [90;300]. Those who did not reach the result had higher leakages [540 g/d, IQR = (300;840)] but obtained clinically significant reduction and reached a median of 90 g/d, IQR = [90;157] after comparable rehabilitation times (median of 6 or 7 sessions, corresponding to 8 or 10 weeks, for rehabilitated and non‐rehabilitated patients, respectively). Future studies will investigate the long‐term results of this programme.

show abstract

Section: Introductionmentioning

confidence: 99%

Developing a rehabilitation programme for male urinary incontinence: detailed schemes and results on 122 patients

Terzoni

Montanari

Mora

et al. 2015

Int J of Uro Nursing

Self Cite

View full text Add to dashboard Cite

show abstract

“…On the other hand, Yamanishi et al 17 and Terzoni et al 18 achieved rates of around 63% but their definition of continence differs greatly from the rest of the studies (carried out in males). The former considered continence as ≤8 g, (the definition accepted at the time for females which took into account the weight of the vaginal flow) which cannot be applied in the case of males since it would skew this percentage.…”

Section: Discussionmentioning

confidence: 93%

Early 3‐month treatment with comprehensive physical therapy program restores continence in urinary incontinence patients after radical prostatectomy: A randomized controlled trial

González

Carrera

Nieto

et al. 2020

Neurourology and Urodynamics

View full text Add to dashboard Cite

Aims The objective of this study is to ascertain whether an early three‐month treatment with electrotherapy and biofeedback restores continence in urinary incontinence patients after radical prostatectomy (RP). Methods Design: The study performed a randomized, controlled trial of parallel and open groups. Configuration: Secondary care, urology department of a university hospital complex. Participants: Patients sent for RP due to prostate cancer (n = 60), 47 patients finally completed the study. Interventions: The treatment group (TG) received physiotherapy consisting of electrotherapy and biofeedback, 3 days a week for 3 months, while the control group (CG) received no specific treatment. Both groups received a guide to perform pelvic floor exercises at home. The measurement instruments used were the 1‐ and 24‐hour pad tests and the International Consultation on Incontinence Questionnaire Short‐Form. The recording method used was a micturition (urinary) diary. Results The results of the 1‐hour pad test (PT) show statistically significant differences between groups at 3 months (P = .001) and 6 months (P = .001), in favor of those in the TG. Sixty‐four percent of patients in the TG recovered continence as against 9.1% in the CG after 3 months in the 1‐hour PT, in line with the objective of this study. Conclusions An early physiotherapy program helps RP patients with urinary incontinence recover continence after 3 months. Moreover, they lead a better quality life.

show abstract

“…After radical retropubic prostatectomy, patients who do not enter rehabilitation have poor continence outcomes (Terzoni et al, , ). In our study, 89.4% of the patients in the PFMT group (93 patients out of 104) and 82.3% in the FES group (28 out of 34) reduced their leakage by 50% or more.…”

Section: Conclusion and Implications For Practicementioning

confidence: 99%

“…40 g/day). In patients with daily losses of at least 100 g, a clinically significant reduction was expected between 4 and 6 weeks: the literature suggests a reduction in daily leakage of at least 50 g (Terzoni et al, 2013a(Terzoni et al, , 2013b. We adopted this criterion, which was realistic for our patients, and considered ineffective PFMT if daily losses were not reduced by at least 50 g after 5 weeks, when patients had initial median leakage of 100 g/day or more.…”

Section: Samplementioning

confidence: 99%

Electrical stimulation for post‐prostatectomy urinary incontinence: is it useful when patients cannot learn muscular exercises?

Terzoni

Montanari

Mora

et al. 2015

Int J of Uro Nursing

Self Cite

View full text Add to dashboard Cite

Urinary incontinence is common after radical prostatectomy. Pelvic floor muscle training (PFMT) and functional electrical stimulation (FES) can be used to reduce urine leakage. Some patients have difficulty in performing PFMT, and do not obtain clinically significant results. FES might be helpful to them, but its role is unclear in the literature. To verify if FES can reduce urine leakage in patients who do not benefit from PFMT. To obtain mid‐term data regarding the persistence of the results through FES or PFMT, associated with a maintenance programme. Prospective and retrospective study (104 PFMT patients, 34 FES) using 24‐h pad‐test to quantify leakage. Rehabilitation ended when patients obtained leakage <10 g/day. Rehabilitated patients followed a maintenance PFMT programme and performed a follow‐up 24‐h pad test after 3 months; 51% (PFMT) and 32% (FES) of patients reached leakage <10 g/day. Overall, 82.3% in the PFMT group and 82.3% in the FES group reduced leakage by at least 50% through rehabilitation. No significant difference existed between the two treatments (p = 0.32). After 3 months, 51 rehabilitated patients out of 56 (PFMT) and 11 out of 11 (FES), respectively, showed persistence of the results. PFMT cannot be replaced by machines, but FES can help those who are unable to execute PFMT to strengthen their sphincter and later learn PFMT. Even those who did not achieve rehabilitation had clinically relevant results in both groups. These methods seem useful for incontinent patients after prostatectomy.

show abstract

Reducing Urine Leakage After Radical Retropubic Prostatectomy: Pelvic Floor Exercises, Magnetic Innervation or No Treatment? A Quasi-Experimental Study

Abstract: PFMEs are useful up to the 3rd month after surgery; ExMI reduces leakages faster than PFMEs.

Cited by 20 publications

References 18 publications

Developing a rehabilitation programme for male urinary incontinence: detailed schemes and results on 122 patients

Developing a rehabilitation programme for male urinary incontinence: detailed schemes and results on 122 patients

Early 3‐month treatment with comprehensive physical therapy program restores continence in urinary incontinence patients after radical prostatectomy: A randomized controlled trial

Electrical stimulation for post‐prostatectomy urinary incontinence: is it useful when patients cannot learn muscular exercises?

Contact Info

Product

Resources

About