Document Detail


Contribution of early intensive prolonged pelvic floor exercises on urinary continence recovery after bladder neck-sparing radical prostatectomy: results of a prospective controlled randomized trial.
MedLine Citation:
PMID:  17487874     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: In this prospective controlled randomized trial we assessed the effects of early, intensive, prolonged pelvic floor exercises (PFE) on urinary incontinence following bladder neck (BN) sparing RRP. METHODS: A sample of 152 patients with localized prostate cancer underwent RRP with BN preservation. Out of this group we randomized 107 incontinent patients into 2 groups. We considered incontinent patients with 24 hr Pad test >2 g. The T group received instructions regarding an intensive program of PFE, from 7 days after catheter removal for as long as any degree of incontinence persisted, within a period of 1 year. The control (C) group did not receive instructions. The outcome was assessed using the 24 hr Pad test, a visual analogue scale (VAS) and a single question of QoL. Results at baseline and at 1, 3, 6, and 12 months were available for 54 and 40 patients, respectively. RESULTS: The overall spontaneous continence rate after catheter removal was 23.6%. The proportion of men still incontinent was significantly higher in the C group than treatment (T) group at 1 (97.5% vs. 83.3%; P = 0.04), 3 (77.5% vs. 53.7%; P = 0.03), 6 (60% vs. 33.3%; P = 0.01), and 12 months (52.5% vs. 16.6%; P < 0.01). Similarly, the VAS and the response to the QoL question at 12 months significantly differed between the two groups (P = 0.01 and 0.03, respectively). CONCLUSIONS: Our study suggests that early intensive prolonged PFE can further increase the number of continent patients and this improvement persists in the first 12 months. The second 6 months following surgery are still useful to recovery.
Authors:
Francesca Manassero; Cinzia Traversi; Valeria Ales; Donatella Pistolesi; Erica Panicucci; Francesca Valent; Cesare Selli
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Neurourology and urodynamics     Volume:  26     ISSN:  0733-2467     ISO Abbreviation:  Neurourol. Urodyn.     Publication Date:  2007  
Date Detail:
Created Date:  2007-10-29     Completed Date:  2008-01-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8303326     Medline TA:  Neurourol Urodyn     Country:  United States    
Other Details:
Languages:  eng     Pagination:  985-9     Citation Subset:  IM    
Copyright Information:
(c) 2007 Wiley-Liss, Inc.
Affiliation:
Department of Urology, University of Pisa, Pisa, Italy. francy_manassero@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Exercise / physiology*
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Pain Measurement
Pelvic Floor / physiopathology*
Physical Therapy Modalities
Prospective Studies
Prostatectomy / adverse effects*,  methods
Prostatic Neoplasms / surgery*
Treatment Outcome
Urinary Bladder / surgery*
Urinary Incontinence / etiology*,  physiopathology,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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