1
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Yang JM, Ye H, Long Y, Zhu Q, Huang H, Xie HY, Luo Y, Zhong YB, Chen J, Wang MY. Effect of pelvic floor muscle training on urinary incontinence after radical prostatectomy: An umbrella review of meta-analysis and systematic review. Clin Rehabil 2023; 37:494-515. [PMID: 36305082 DOI: 10.1177/02692155221136046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To analyse the specific exercise effects of pelvic floor muscle training (PFMT) with or without biofeedback or electrical stimulation on urinary incontinence rehabilitation after radical prostatectomy. DATA SOURCES We searched PubMed, Embase, Cochrane Database of Systematic Reviews, Web of Science and Scopus databases for systematic reviews and meta-analyses on PFMT for urinary incontinence after radical prostatectomy from inception to 3 October 2022. REVIEW METHODS Two authors independently extracted key data from the included studies. The methodological quality of the included studies was assessed using the A Measure Tool to Assess Systematic Reviews-2 checklist. Grading of Recommendations Assessment Development and Evaluation was used to evaluate the quality of the outcomes. RESULTS A total of 18 studies with 29,925 patients were included, all of which were of critically low methodological quality. Biofeedback therapy seemed to show additional benefits compared to PFMT alone; however, the adjunctive role of electrical stimulation remained more controversial due to the lack of strong evidence. Preoperative PFMT sometimes, but not always, showed the potential to improve urinary incontinence. PFMT with the guidance of a therapist could bring some benefits to the patient and was more acceptable to the patient, but consumed some medical resources. CONCLUSIONS PFMT has a good effect on improving post-radical prostatectomy incontinence in men, and biofeedback can have an additional beneficial effect on patients, especially in the short-term and medium-term. However, there is insufficient evidence to suggest that electrical stimulation is beneficial for patients with urinary incontinence.
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Affiliation(s)
- Jia-Ming Yang
- Department of Rehabilitation Medicine, 477808First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.,74554Gannan Medical University, Ganzhou, Jiangxi, China
| | - Hua Ye
- 74554Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yi Long
- 74554Gannan Medical University, Ganzhou, Jiangxi, China
| | - Qiang Zhu
- Department of Rehabilitation Medicine, 477808First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Hui Huang
- Department of Rehabilitation Medicine, 477808First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Hui-Yong Xie
- 74554Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yun Luo
- Department of Rehabilitation Medicine, 477808First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yan-Biao Zhong
- Department of Rehabilitation Medicine, 477808First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.,Ganzhou Intelligent Rehabilitation Technology Innovation Center, Ganzhou, Jiangxi, China
| | - Jing Chen
- Department of Rehabilitation Medicine, 477808First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Mao-Yuan Wang
- Department of Rehabilitation Medicine, 477808First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.,Ganzhou Key Laboratory of Rehabilitation Medicine, Ganzhou, Jiangxi, China
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2
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Kadono Y, Nohara T, Kawaguchi S, Naito R, Kadomoto S, Iwamoto H, Yaegashi H, Shigehara K, Izumi K, Yoshida K, Gabata T, Mizokami A. Contribution of Retzius-sparing robot-assisted radical prostatectomy to the mechanism of urinary continence as demonstrated by dynamic MRI. Sci Rep 2023; 13:2902. [PMID: 36801949 PMCID: PMC9938893 DOI: 10.1038/s41598-023-30132-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/16/2023] [Indexed: 02/20/2023] Open
Abstract
Retzius-sparing robot-assisted radical prostatectomy (RARP) has been reported to exhibit better postoperative urinary continence, but the reasons behind this are unknown. This study included 254 cases who underwent RARP and underwent postoperative dynamic MRI. We measured the urine loss ratio (ULR) immediately after postoperative urethral catheter removal and investigated its affecting factors and the mechanisms. Nerve-sparing (NS) techniques was performed in 175 (69%) unilateral and 34 (13%) bilateral cases, whereas Retzius-sparing in 58 (23%) cases. The median ULR early after indwelling catheter removal in all patients was 4.0%. The multivariate analysis was performed on factors that reduce ULR and found that the following factors were associated with ULR: younger age, NS and Retzius-sparing, which were significant. Additionally, dynamic MRI findings showed that membranous urethral length and the anterior rectal wall movement toward the pubic bone during abdominal pressure were significant factors. The movement observed on the dynamic MRI during abdominal pressure was thought to reflect an effective urethral sphincter closure mechanism. Long membranous urethral length and an effective urethral sphincter closure mechanism during abdominal pressure were considered effective for favorable urinary continence after RARP. NS and Retzius-sparing were clearly shown to have an additive effect in preventing urinary incontinence.
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Affiliation(s)
- Yoshifumi Kadono
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan.
| | - Takahiro Nohara
- grid.9707.90000 0001 2308 3329Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8640 Japan
| | - Shohei Kawaguchi
- grid.9707.90000 0001 2308 3329Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8640 Japan
| | - Renato Naito
- grid.9707.90000 0001 2308 3329Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8640 Japan
| | - Suguru Kadomoto
- grid.9707.90000 0001 2308 3329Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8640 Japan
| | - Hiroaki Iwamoto
- grid.9707.90000 0001 2308 3329Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8640 Japan
| | - Hiroshi Yaegashi
- grid.9707.90000 0001 2308 3329Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8640 Japan
| | - Kazuyoshi Shigehara
- grid.9707.90000 0001 2308 3329Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8640 Japan
| | - Kouji Izumi
- grid.9707.90000 0001 2308 3329Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8640 Japan
| | - Kotaro Yoshida
- grid.9707.90000 0001 2308 3329Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Toshifumi Gabata
- grid.9707.90000 0001 2308 3329Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Atsushi Mizokami
- grid.9707.90000 0001 2308 3329Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8640 Japan
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3
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Steenstrup B, Cartier M, Nouhaud F, Kerdelhue G, Gilliaux M. A systematic review of supervised comprehensive functional physiotherapy after radical prostatectomy. Prog Urol 2022; 32:525-539. [DOI: 10.1016/j.purol.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/19/2022] [Accepted: 04/24/2022] [Indexed: 10/18/2022]
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Al‐Zaidi Z, Lindam A, Fransson P, Samuelsson E. A mobile app as support for pelvic floor muscle training started prior to radical prostatectomy. BJUI COMPASS 2022; 4:114-122. [PMID: 36569504 PMCID: PMC9766858 DOI: 10.1002/bco2.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 01/20/2022] [Accepted: 01/30/2022] [Indexed: 12/27/2022] Open
Abstract
Objective To evaluate the usefulness of a mobile app to support pelvic floor muscle training (PFMT) started prior to radical prostatectomy (RP). Materials and methods A prospective cohort study conducted in Sweden from June 2018 to February 2021 including men for whom RP was planned within 12 months. Users responded anonymously to questionnaires at baseline, 1 and 3 months. Our primary aim was to evaluate if the app could facilitate PFMT and increase confidence in performing pelvic floor muscle (PFM) contractions correctly. Our second aim was to describe the change in urinary incontinence (UI) after RP, based on the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Results Of the 3043 users at baseline, 388 met the primary inclusion criteria. Of those, 71 (18.3%) were incontinent, predominantly with slight symptoms. The most common type was urge UI, 39/71 (54.9%). Of the 388 users, 159 (41.0%) answered the questionnaire at 1 month, and 131 (33.7%) at 3 months within 89-135 days. Of those 131, 127 (96.9%) indicated that the app facilitated their training 'a lot' or 'somewhat'. Confidence in performing PFM contractions correctly increased from 39.7% at baseline to 74.0% at 1 month and 87.8% at 3 months (p < 0.001). At baseline, 19.8% performed PFM contractions at least daily, which increased to 74.0% at 1 month and 77.9% at 3 months (p < 0.001). At 3 months, 115/131 (87.8%) had undergone RP, 93.6% of which were robot-assisted. Of the 115, 103 (89.6%) were incontinent, and stress UI dominated. The mean ICIQ-UI SF score increased from 1.2 (2.4 SD) at baseline to 9.6 (5.2 SD), p < 0.001, after surgery. Conclusions The mobile app facilitated pelvic floor muscle training for men who were planned to undergo radical prostatectomy and used the app.
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Affiliation(s)
- Zinah Al‐Zaidi
- Family Medicine, Department of Public Health and Clinical MedicineUmeå UniversityUmeåSweden
| | - Anna Lindam
- Unit of Research, Education, and Development, Östersund Hospital, Department of Public Health and Clinical MedicineUmeå UniversityUmeåSweden
| | | | - Eva Samuelsson
- Family Medicine, Department of Public Health and Clinical MedicineUmeå UniversityUmeåSweden
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Reichert M, Popeneciu IV, Uhlig A, Trojan L, Mohr MN. Cognitive Ability as a Non-modifiable Risk Factor for Post-prostatectomy Urinary Incontinence: A Double-Blinded, Prospective, Single-Center Trial. Front Surg 2022; 8:812197. [PMID: 35083274 PMCID: PMC8784528 DOI: 10.3389/fsurg.2021.812197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/13/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Urinary incontinence (UI) is a wide-spread and feared side-effect of conventional or even robot-assisted laparoscopic prostatectomy (RALP) due to its high impact on patients' quality of life (QoL). Non-modifiable risk factors for UI have already been identified - on surgical and patient side. Yet, to our knowledge, focus thus far has not been placed on functional aspects regarding general cognitive ability. Materials and Methods: This is an observational single-center, prospective, double-blinded evaluation of 109 RALPs performed between 07/2020 and 03/2021. All patients underwent a Mini Mental State Examination (MMSE) prior to surgery to evaluate their cognitive ability. Early post-prostatectomy incontinence (PPI) was evaluated using a standardized 1 h pad test performed 24 h after removal of the urinary catheter. The association between MMSE results and PPI were evaluated using univariate and multivariate logistic regression models. Results: Multivariate logistic regression analyses identified MMSE results and nerve sparing (NS) as independent predictors for PPI in patients with an intermediate MMSE result (25-27 points) having a 3.17 times higher risk of PPI when compared to patients with a good MMSE result (≥28) (95% Confidence Interval (CI): 1.22-9.06, p = 0.023), while patients without NS had a 3.53 times higher risk of PPI when compared to patients with NS (95% CI: 1.54-11.09, p = 0.006). Conclusion: A lower cognitive ability should be treated as a non-modifiable risk-factor for early PPI. In the future it could find its place as a clinical screening tool to identify patients who require more attention especially in the pre-, but also in the postoperative phase.
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Affiliation(s)
- Mathias Reichert
- Department of Urology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Annemarie Uhlig
- Department of Urology, University Medical Center Göttingen, Göttingen, Germany
| | - Lutz Trojan
- Department of Urology, University Medical Center Göttingen, Göttingen, Germany
| | - Mirjam Naomi Mohr
- Department of Urology, University Medical Center Göttingen, Göttingen, Germany
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6
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Chalmers KJ, Elkins MR. Pelvic health. J Physiother 2022; 68:5-6. [PMID: 34916159 DOI: 10.1016/j.jphys.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022] Open
Affiliation(s)
- K Jane Chalmers
- IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Mark R Elkins
- Editor, Journal of Physiotherapy; Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
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7
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Cowley D, Stafford RE, Hodges PW. The repeatability of measurements of male pelvic floor anatomy and function made from transperineal ultrasound images of healthy men and those before and after prostatectomy. Neurourol Urodyn 2021; 40:1539-1549. [PMID: 34130355 DOI: 10.1002/nau.24701] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/20/2021] [Accepted: 05/03/2021] [Indexed: 11/09/2022]
Abstract
AIMS To investigate the inter- and intratester repeatability of measurement of the location and displacement of five pelvic landmarks related to pelvic floor muscles with transperineal ultrasound (TPUS) imaging recorded from healthy men and men before and after prostatectomy. METHODS TPUS images were selected from four different participant groups: healthy men, men awaiting prostatectomy, men 2 weeks after prostatectomy, and men 12 months after prostatectomy. On two separate occasions, two assessors with different levels of experience performed analysis of location and displacement of five pelvic landmarks in images made at rest and during voluntary contraction. A two-way mixed effects, single measurement, absolute agreement intraclass correlation coefficient (ICC) was used to investigate the repeatability. RESULTS Intertester reliability of all locations at rest for all groups was excellent (ICCs > 0.8) except for the craniocaudal coordinate of the ventral urethrovesical junction for men 2 weeks postprostatectomy and the anorectal junction for men with a cancerous prostate. Intertester reliability of the measurement of landmark displacement was acceptable (>0.5) for the dorsoventral axis of motion but not for the craniocaudal axis of motion for all landmarks across all groups. The more experienced assessor was consistently more repeatable. More deeply placed landmarks were more often excluded from analysis and had poorer reliability. CONCLUSIONS Analysis of TPUS images across clinical groups is repeatable for both location and displacement of pelvic landmarks related to pelvic floor muscles when measures are made twice. Analysis experience, landmark depth and optimization of ultrasound settings appear to be important factors in reliability.
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Affiliation(s)
- David Cowley
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Ryan E Stafford
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Division of Exercise Science, School of Human Sciences, The University of Western Australia, Perth, Australia
| | - Paul W Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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8
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Mungovan SF, Carlsson SV, Gass GC, Graham PL, Sandhu JS, Akin O, Scardino PT, Eastham JA, Patel MI. Preoperative exercise interventions to optimize continence outcomes following radical prostatectomy. Nat Rev Urol 2021; 18:259-281. [PMID: 33833445 PMCID: PMC8030653 DOI: 10.1038/s41585-021-00445-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 01/31/2023]
Abstract
Urinary incontinence is a common and predictable consequence among men with localized prostate cancer who have undergone radical prostatectomy. Despite advances in the surgical technique, urinary continence recovery time remains variable. A range of surgical and patient-related risk factors contributing to urinary incontinence after radical prostatectomy have been described, including age, BMI, membranous urethral length and urethral sphincter insufficiency. Physical activity interventions incorporating aerobic exercise, resistance training and pelvic floor muscle training programmes can positively influence the return to continence in men after radical prostatectomy. Traditional approaches to improving urinary continence after radical prostatectomy have typically focused on interventions delivered during the postoperative period (rehabilitation). However, the limited efficacy of these postoperative approaches has led to a shift from the traditional reactive model of care to more comprehensive interventions incorporating exercise-based programmes that begin in the preoperative period (prehabilitation) and continue after surgery. Comprehensive prehabilitation interventions include appropriately prescribed aerobic exercise, resistance training and specific pelvic floor muscle instruction and exercise training programmes. Transperineal ultrasonography is a non-invasive and validated method for the visualization of the action of the pelvic floor musculature, providing real-time visual biofeedback to the patient during specific pelvic floor muscle instruction and training. Importantly, the waiting time before surgery can be used for the delivery of comprehensive prehabilitation exercise-based interventions to increase patient preparedness in the lead-up to surgery and optimize continence and health-related quality-of-life outcomes following radical prostatectomy.
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Affiliation(s)
- Sean F Mungovan
- Westmead Private Physiotherapy Services, Westmead Private Hospital, Westmead, New South Wales, Australia.
- The Clinical Research Institute, Westmead, New South Wales, Australia.
- Department of Professions, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia.
| | - Sigrid V Carlsson
- Urology Service at the Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Institute of Clinical Sciences, Department of Urology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Gregory C Gass
- The Clinical Research Institute, Westmead, New South Wales, Australia
- Physical Therapy Program, University of Jamestown, Fargo, ND, USA
| | - Petra L Graham
- Department of Mathematics and Statistics, Macquarie University, Macquarie Park, New South Wales, Australia
| | - Jaspreet S Sandhu
- Urology Service at the Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Oguz Akin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peter T Scardino
- Urology Service at the Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - James A Eastham
- Urology Service at the Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Manish I Patel
- Specialty of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Department of Urology, Westmead Hospital, Westmead, New South Wales, Australia
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9
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Nahon I. Physiotherapy management of incontinence in men. J Physiother 2021; 67:87-94. [PMID: 33753017 DOI: 10.1016/j.jphys.2021.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/19/2021] [Indexed: 12/24/2022] Open
Affiliation(s)
- Irmina Nahon
- Discipline of Physiotherapy, Faculty of Health, University of Canberra, Australia.
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10
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Schifano N, Capogrosso P, Tutolo M, Dehò F, Montorsi F, Salonia A. How to Prevent and Manage Post-Prostatectomy Incontinence: A Review. World J Mens Health 2020; 39:581-597. [PMID: 33151045 PMCID: PMC8443978 DOI: 10.5534/wjmh.200114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/25/2020] [Accepted: 08/14/2020] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To provide an overview of the currently available evidence relating to the prevention and management strategies of urinary incontinence (UI) after radical prostatectomy (RP). MATERIALS AND METHODS A comprehensive research was carried out on MEDLINE/PubMed database to identify pertinent studies concerning post-RP UI. The search strategy included these words: urinary continence; urinary continence recovery; urinary incontinence; radical prostatectomy; and prostate cancer. RESULTS Post-RP UI still represents a challenging issue for both urologic patients and clinicians. A complete preoperative assessment of the risk factors associated with post-RP UI aids both in counseling those patients with a higher estimated likelihood of postoperative UI and in identifying those who would probably benefit from preventive strategies in the preoperative and in the intraoperative settings. Over the last decades different surgical strategies based on either the "preservation" or the "reconstruction" of the anatomical elements responsible for urinary continence (UC) led to an overall improvement of postoperative functional outcomes. Finally, several therapeutic strategies should be evaluated for the postoperative UI management. Artificial urinary sphincter implantation represents the gold standard for treatment, notwithstanding its wide adoption is limited due to high costs and significant risk of surgical revision. In this context, male sling positioning seems the most promising strategy, in particular in mild and moderate post-RP UI. CONCLUSIONS To enhance the likelihood of obtaining an optimal UC recovery after RP, it is here strongly suggested to intervene throughout the overall clinical management process thus including the pre-, intra- and postoperative settings.
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Affiliation(s)
- Nicolò Schifano
- Università Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Paolo Capogrosso
- Unit of Urology, ASST Sette Laghi - Circolo e Fondazione Macchi Hospital, Varese, Italy.
| | - Manuela Tutolo
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Federico Dehò
- Unit of Urology, ASST Sette Laghi - Circolo e Fondazione Macchi Hospital, Varese, Italy.,University of Insubria, Varese, Italy
| | - Francesco Montorsi
- Università Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Salonia
- Università Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
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11
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Sayner A, Nahon I. Pelvic Floor Muscle Training in Radical Prostatectomy and Recent Understanding of the Male Continence Mechanism: A Review. Semin Oncol Nurs 2020; 36:151050. [PMID: 32674975 DOI: 10.1016/j.soncn.2020.151050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Pelvic floor muscle training (PFMT) is recommended as part of supportive care for patients with prostate cancer. It can assist in reducing treatment-related symptoms such as urinary incontinence. This literature review aims to discuss recent innovative findings on the pathophysiology of the male continence mechanism and implications for PFMT in radical prostatectomy. DATA SOURCES CINAHL, Embase, Web of Science, Emcare and PsycINFO were searched until January 2020. CONCLUSION Nurses providing supportive care for patients undergoing radical prostatectomy can engage in-clinic in the instruction and recommendation of pre- and postoperative PFMT and delivering guidance on home-based programs to promote motor learning. IMPLICATIONS FOR NURSING PRACTICE Optimal postoperative urinary incontinence outcomes are suggested to be promoted by preoperative PFMT. Training focused on the urethral and anterior pelvic floor muscle complex has been shown to facilitate mid urethral occlusion required for continence. Prescription of PFMT should be individualised, focusing on skill acquisition and motor learning, which is in line with recent knowledge developments in male pelvic floor anatomy.
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Affiliation(s)
- Alesha Sayner
- University of Canberra, Australian Capital Territory, Australia; Western Health, Chronic and Complex Care/Physiotherapy Department, Melbourne, Australia; Australian Prostate Centre, Melbourne, Australia.
| | - Irmina Nahon
- University of Canberra, Australian Capital Territory, Australia
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