Pre-operative pelvic floor exercises improve continence recovery after prostate surgery
MedWire News: Practicing pelvic floor muscle exercises (PFME) before prostate surgery may improve rates of urinary continence and quality of life scores post-surgery, according to Italian research results.
Patients who started PFME 30 days before radical prostatectomy and continued postoperatively showed greater improvement in urinary continence than men who only did the exercises postoperatively.
“The results of this study show that 30 day preoperative PFME training can decrease the duration and severity of incontinence following nerve-sparing open radical prostatectomy at 1 and 3 months,” report Giorgio Guazzoni, from San Raffaele Hospital in Milan, and colleagues.
The 118 patients involved in the study all had clinically localized prostate cancer (stage T1–T2a–b) and were randomly assigned to either group A (n=59) who began PFME 30 days before surgery, or group B (n=59) who only exercised afterwards.
The men reported their continence status 1 and 3 months after surgery, and underwent a undergoing a 24 hour pad test to examine the degree of urinary incontinence, as well as completing the International Continence Society (ICS) male short form (SF) where a lower score denotes a better outcome.
Immediately after catheter removal, 21 patients in group A and 14 patients in group B reported urinary continence. At 1 month after surgery, the difference between the groups became statistically significant with 26 patients in group A, and 12 patients in group B reporting continence, note the researchers.
The difference between the two groups remained significant at 3 months, when 35 patients in group A and 22 patients in group B were continent.
The ICS male SF scores were also better for group A than group B with significantly different mean scores of 14.6 versus 18.3, respectively, at 1 month after surgery and 8.1 versus 12.2 after 3 months.
Results of the 24-hour pad test followed the same trend, with 25.4% and 33.9% of men in group A and B, respectively, having a pad weighing above 150 g at one month after surgery, and 16.9% compared with 32.2% at 3 months.
“Our results seem to support the suggestion that preoperative action may improve early continence after radical prostatectomy,” write the researchers in the journal European Urology.
The team concludes: “Further studies are mandatory in order to confirm and implement our data in clinical practice.”
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By Sarah Guy