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Leao Ribeiro I, Lorca LA, Peviani Messa S, Berríos Contreras L, Valdivia Valdés FJ, Roteli Oyarzún VD, Rojas Soto CA. [Effectiveness of early pelvic muscle training on pelvic floor strength, urinary incontinence symptoms, sexual function, and quality of life in post-radical prostatectomy patients: Systematic review of randomized clinical trials]. Rehabilitacion (Madr) 2024; 58:100828. [PMID: 38141425 DOI: 10.1016/j.rh.2023.100828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 07/07/2023] [Accepted: 08/07/2023] [Indexed: 12/25/2023]
Abstract
This study aimed to evaluate the effectiveness of early pelvic muscle training in reducing urinary incontinence symptoms, improving quality of life, sexual function, and increasing pelvic floor strength in post-radical prostatectomy patients. A search was carried out in 8 databases until October 26, 2022, the methodological quality and the risk of bias of 14 included studies (n=1236) were evaluated, moreover, the evidence and the meta-analysis were calculated. The intervention significantly reduced urinary incontinence symptoms compared to a control group (SMD=-2.80, 95% CI=-5.21 to -0.39, P=.02), with significant heterogeneity (I2=83%; P=<.0001) and moderate evidence. In addition, it presented moderate evidence to improve quality of life, and very low evidence to improve sexual function and pelvic floor strength. These results should be viewed with caution due to the significant heterogeneity of the studies analysed.
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Affiliation(s)
- I Leao Ribeiro
- Departmento de Kinesiología, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile.
| | - L A Lorca
- Hospital del Salvador, Servicio de Salud Metropolitano Oriente, Santiago de Chile, Chile
| | | | | | - F J Valdivia Valdés
- Departmento de Kinesiología, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile
| | - V D Roteli Oyarzún
- Departmento de Kinesiología, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile
| | - C A Rojas Soto
- Departmento de Kinesiología, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile
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An D, Wang J, Zhang F, Jing H, Gao Y, Cong H, Su G, Ye M, Hu C, Wu J, Liao L. Effect of Pilates combined with pelvic floor muscle training on continence of post-prostatectomy incontinence in patients with different body mass index. BMC Urol 2024; 24:74. [PMID: 38549067 PMCID: PMC10976754 DOI: 10.1186/s12894-024-01451-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/07/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Urinary incontinence symptoms severely affect older people with different body mass index (BMI).To compare the efficacy of the pelvic floor muscle training (PFMT) in patients with post-prostatectomy incontinence with different BMI. METHODS Thirty-seven patients with post-prostatectomy incontinence were included. They were divided into group A (BMI ≤ 25,12), group B (26 ≤ BMI ≤ 30,14), and group C (BMI ≥ 31,11) based on difference BMI. Three groups of patients underwent the same Pilates combined with kegel training. Participants were assessed with 1-hour pad test, the number of incontinence episodes, International Consultation on Incontinence Questionnaire and Oxford Grading Scale. RESULTS In the 1-hour pad test, the differences before and after training were statistically significant in all three groups of participants. Group A decreased from 81.83 ± 8.79 to 31.08 ± 5.64 g (P < 0.01). Group B decreased from 80.57 ± 8.87 to 35.85 ± 5.66 g (P < 0.01). Group C decreased from 83.55 ± 10.24 to 40.18 ± 7.01 g (P < 0.01). The number of incontinent episodes in group A decreased from 9.33 ± 1.07 to 3.25 ± 0.62 (P < 0.01). Group B decreased from 8.86 ± 1.09 to 3.79 ± 0.80 (P < 0.01). Group C decreased from 9.27 ± 1.10 to 4.09 ± 0.70 (P < 0.01). The correlation between the three groups of participants and the 1-hour pad test, with an R2 of 0.51. The correlation between the three groups of participants and the number of urinary incontinence episodes with a R2 of 0.43. CONCLUSIONS Pelvic floor muscle training can affect the recovery of urinary continence in patients with different BMI. Maintaining a lower BMI can be beneficial for improving urinary control. TRIAL REGISTRATION Date of trial registration: November 27, 2023.
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Affiliation(s)
- Di An
- Department of physiotherapy 2 (PT2), China Rehabilitation Research Center the School of Rehabilitation, Capital Medical University, NO 10, Jiaomen Beilu, Fengtai district, Beijing, 100068, China
| | - Jianxia Wang
- Department of Intensive Care Unit, Cancer Hospital Chinese Academy of Medical Science, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Beijing, China
| | - Fan Zhang
- Department of Urology, China Rehabilitation Research Center, Fengtai district, Beijing, China
| | - Huafang Jing
- Department of Urology, China Rehabilitation Research Center, Fengtai district, Beijing, China
| | - Yi Gao
- Department of Urology, China Rehabilitation Research Center, Fengtai district, Beijing, China
| | - Huiling Cong
- Department of Urology, China Rehabilitation Research Center, Fengtai district, Beijing, China
| | - Guodong Su
- Department of physiotherapy 3(PT3), China Rehabilitation Research Center, Fengtai district, Beijing, China
| | - Miao Ye
- Department of physiotherapy 2 (PT2), China Rehabilitation Research Center the School of Rehabilitation, Capital Medical University, NO 10, Jiaomen Beilu, Fengtai district, Beijing, 100068, China
| | - Chunying Hu
- Department of physiotherapy 2 (PT2), China Rehabilitation Research Center the School of Rehabilitation, Capital Medical University, NO 10, Jiaomen Beilu, Fengtai district, Beijing, 100068, China
| | - Juan Wu
- Department of Urology, China Rehabilitation Research Center, Fengtai district, Beijing, China
| | - Limin Liao
- China Rehabilitation Research Center (CRRC), Department of Urology of Beijing Boai Hospital, Department of Urology of Capital Medical University, NO 10, Jiaomen Beilu, Beijing, 100068, China.
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Steenstrup B, Cartier M, Cornu JN. What more comprehensive physiotherapy techniques than pelvic floor muscles training should be investigated in the context of post-prostatectomy? A narrative review. Prog Urol 2023; 33:1092-1100. [PMID: 37798160 DOI: 10.1016/j.purol.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/04/2023] [Accepted: 09/14/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND In a previous article, we have underlined the emerging level of evidence for the effectiveness of a more comprehensive functional physical therapy than solely pelvic floor muscles training (PFMT) for men after radical prostatectomy (RP). More and more authors suggest that physiotherapy programs should not focus only on the side effect of continence, but more generally on the interaction of continence disorders with all other side effects related to patient's physical and emotional functioning. RESEARCH QUESTION The aims of this narrative review are to highlight rehabilitation approaches unrelated to analytical PFMT that would seem relevant to consider in the future for post-RP men. METHOD Our narrative review sought to map the body of literature relevant to the primary objective (non-PFMT), supplementing the data from our previous review with additional recent articles that were not eligible due to not meeting the inclusion criteria for a systematic review. RESULTS After full text screening, 13 interventional studies have been selected. Intervention strategies were based on five major type of exercises: flexibility, synergism & co-activation, coordination & movement control, strength & endurance, aerobic & games therapy. Most of the studies of this narrative review focused on synergies, co-activations and movement control techniques that emphasized the deep abdominal muscles and PFMs reflexive activation. The wide variety of countries represented in the 13 studies with consistent results point to the potential effectiveness and replicability across various socio-cultural, ethnical, or religious contexts. CONCLUSION We found 13 studies from 9 different countries that provide a more complete rehabilitation approach than PFMT alone in men post-RP. Intervention strategies were built around five main types of exercises, with the majority of them emphasizing synergies, co-activations, and movement control techniques. In light of these data, we hope that future research will enable us to offer the most relevant and patient-centered physiotherapy treatment.
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Affiliation(s)
- B Steenstrup
- Rouen University Hospital, Department of Urology, Rouen, France; La Musse Physiotherapy Training Institute, Saint-Sébastien-de-Morsent, France.
| | - M Cartier
- La Musse Physiotherapy Training Institute, Saint-Sébastien-de-Morsent, France
| | - J N Cornu
- Rouen University Hospital, Department of Urology, Rouen, France
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Puig-Saenz C, Pearson JRD, Thomas JE, McArdle SEB. A Holistic Approach to Hard-to-Treat Cancers: The Future of Immunotherapy for Glioblastoma, Triple Negative Breast Cancer, and Advanced Prostate Cancer. Biomedicines 2023; 11:2100. [PMID: 37626597 PMCID: PMC10452459 DOI: 10.3390/biomedicines11082100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
Immunotherapy represents an attractive avenue for cancer therapy due to its tumour specificity and relatively low frequency of adverse effects compared to other treatment modalities. Despite many advances being made in the field of cancer immunotherapy, very few immunotherapeutic treatments have been approved for difficult-to-treat solid tumours such as triple negative breast cancer (TNBC), glioblastoma multiforme (GBM), and advanced prostate cancer (PCa). The anatomical location of some of these cancers may also make them more difficult to treat. Many trials focus solely on immunotherapy and have failed to consider or manipulate, prior to the immunotherapeutic intervention, important factors such as the microbiota, which itself is directly linked to lifestyle factors, diet, stress, social support, exercise, sleep, and oral hygiene. This review summarises the most recent treatments for hard-to-treat cancers whilst factoring in the less conventional interventions which could tilt the balance of treatment in favour of success for these malignancies.
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Affiliation(s)
- Carles Puig-Saenz
- The John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, College Drive, Clifton, Nottingham NG11 8NS, UK; (C.P.-S.); (J.R.D.P.); (J.E.T.)
- Centre for Systems Health and Integrated Metabolic Research, School of Science and Technology, Nottingham Trent University, College Drive, Clifton, Nottingham NG11 8NS, UK
| | - Joshua R. D. Pearson
- The John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, College Drive, Clifton, Nottingham NG11 8NS, UK; (C.P.-S.); (J.R.D.P.); (J.E.T.)
- Centre for Systems Health and Integrated Metabolic Research, School of Science and Technology, Nottingham Trent University, College Drive, Clifton, Nottingham NG11 8NS, UK
| | - Jubini E. Thomas
- The John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, College Drive, Clifton, Nottingham NG11 8NS, UK; (C.P.-S.); (J.R.D.P.); (J.E.T.)
- Centre for Systems Health and Integrated Metabolic Research, School of Science and Technology, Nottingham Trent University, College Drive, Clifton, Nottingham NG11 8NS, UK
| | - Stéphanie E. B. McArdle
- The John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, College Drive, Clifton, Nottingham NG11 8NS, UK; (C.P.-S.); (J.R.D.P.); (J.E.T.)
- Centre for Systems Health and Integrated Metabolic Research, School of Science and Technology, Nottingham Trent University, College Drive, Clifton, Nottingham NG11 8NS, UK
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Gezginci E, Goktas S, Ata A. Effect of perioperative pelvic floor muscle training program on incontinence and quality of life after radical prostatectomy: A randomized controlled trial. Clin Rehabil 2023; 37:534-544. [PMID: 36263522 DOI: 10.1177/02692155221134477] [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: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of a perioperative pelvic floor muscle training program on urinary incontinence symptoms and the quality of life of patients after radical prostatectomy. METHODS This single-center, parallel-group, randomized, controlled study was conducted with a total of 60 patients undergoing open radical prostatectomy in a training and research hospital in Turkey. Patients were randomly assigned to the pelvic floor muscle training group (n = 30) and the control group (n = 30). The data were collected by face-to-face and phone interviews following surgery at seven days after removal of the urethral catheter (baseline) and 3 months using the Patient Information Form, the International Consultation on Incontinence Questionnaire Short Form and the International Consultation on Incontinence Questionnaire for Male Lower Urinary Tract Symptoms. Descriptive statistics, Chi-square test, Independent-samples t-test, and paired-samples test were used to analyze the data. Primary and secondary endpoints were the differences between groups in terms of both scale scores after 3 months. FINDINGS After 3 months, Incontinence Questionnaire Short Form scores (P < 0.001) and "voiding, incontinence, frequency, nocturia" symptoms scores (P < 0.001) were significantly lower in the pelvic floor muscle training group, and quality of life scores were higher than in the control group (P < 0.001). CONCLUSION According to this study, the perioperative pelvic floor muscle training program was effective on patients' urinary incontinence symptoms and quality of life 3 months after radical prostatectomy. Evidence-based practices should be used for patients to alleviate common urinary symptoms and to accelerate the recovery of urinary continence.
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Affiliation(s)
- Elif Gezginci
- Department of Surgical Nursing, Hamidiye Faculty of Nursing, 448249University of Health Sciences Turkey, Istanbul, Turkey
| | - Sonay Goktas
- Department of Surgical Nursing, Hamidiye Faculty of Nursing, 448249University of Health Sciences Turkey, Istanbul, Turkey
| | - Aysenur Ata
- Department of Urology, Istanbul Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
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Mazur-Bialy A, Tim S, Kołomańska-Bogucka D, Burzyński B, Jurys T, Pławiak N. Physiotherapy as an Effective Method to Support the Treatment of Male Urinary Incontinence: A Systematic Review. J Clin Med 2023; 12:jcm12072536. [PMID: 37048619 PMCID: PMC10095040 DOI: 10.3390/jcm12072536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/05/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Urinary incontinence (UI) is a serious health issue that affects both women and men. The risk of UI increases in men with age and after treatment for prostate cancer and affects up to 32% of men. Furthermore, UI may affect up to 69% of men after prostatectomy. Considering such a high incidence, it is critical to search for effective methods to mitigate this issue. Hence, the present review aims to provide an overview of physiotherapeutic methods and evaluate their effectiveness in treating UI in men. This systematic review was performed using articles included in PubMed, Embase, WoS, and PEDro databases. A total of 6965 relevant articles were found. However, after a risk of bias assessment, 39 studies met the inclusion criteria and were included in the review. The research showed that the available physiotherapeutic methods for treating men with UI, including those after prostatectomy, involve pelvic floor muscle training (PFMT) alone or in combination with biofeedback (BF) and/or electrostimulation (ES), vibrations, and traditional activity. In conclusion, PFMT is the gold standard of UI therapy, but it may be complemented by other techniques to provide a personalized treatment plan for patients. The effectiveness of the physiotherapeutic methods varies from study to study, and large methodological differences make it difficult to accurately compare individual results and draw unequivocal conclusions.
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Affiliation(s)
- Agnieszka Mazur-Bialy
- Department of Biomechanics and Kinesiology, Faculty of Health Science, Jagiellonian University Medical College, Skawińska 8, 31-066 Krakow, Poland
- Correspondence: ; Tel.: +48-012-421-9351
| | - Sabina Tim
- Department of Biomechanics and Kinesiology, Faculty of Health Science, Jagiellonian University Medical College, Skawińska 8, 31-066 Krakow, Poland
| | - Daria Kołomańska-Bogucka
- Department of Biomechanics and Kinesiology, Faculty of Health Science, Jagiellonian University Medical College, Skawińska 8, 31-066 Krakow, Poland
| | - Bartłomiej Burzyński
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Tomasz Jurys
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Natalia Pławiak
- University Hospital in Krakow, Jakubowskiego 2, 30-688 Krakow, Poland
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Chen S, Wang S, Liu S, Wang S, Xuan L, Gao Y. Efficacy of electrical pudendal nerve stimulation versus pelvic floor muscle training in treating postradical prostatectomy urinary incontinence: study protocol for a randomised controlled trial. BMJ Open 2023; 13:e062323. [PMID: 36604129 PMCID: PMC9827247 DOI: 10.1136/bmjopen-2022-062323] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Urinary incontinence (UI) is one of the main complications of radical prostatectomy. Electrical pudendal nerve stimulation (EPNS) has been used to treat stress UI based on its mechanism of passive pelvic floor muscle contraction reported in the previous research. However, there are no studies comparing the effects of EPNS and active pelvic floor muscle training (PFMT) in the treatment of postradical prostatectomy UI (PPUI). Here, we describe the protocol for a randomised controlled trial to evaluate the efficacy of EPNS in treating PPUI compared with PFMT. METHODS AND ANALYSIS This study is designed as an open-label randomised controlled trial with blinded assessment and analysis. A total of 90 eligible men will be randomly allocated to two groups. The treatment group (n=45) will receive EPNS while the control group will perform PFMT by doing the Kegel exercise. Forty EPNS treatment sessions will occur over a period of 8 weeks. The primary outcome measure will be improvement rate, and the secondary outcome measures, the number of pads used, 24-hour pad test, and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form will be compared between baseline and the study endpoint. The International Consultation on Incontinence Questionnaire-Lower Urinary Tract Symptoms Quality of Life and care compared as the quality of life and satisfaction outcomes between groups. ETHICS AND DISSEMINATION This protocol has been approved by the Ethics Committee of the First Affiliated Hospital of Zhejiang Chinese Medical University (approval no. 2021 KL-040-02). Written informed consent will be obtained from each participant. The results of the study will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ChiCTR2200055461.
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Affiliation(s)
- Shan Chen
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Siyou Wang
- Clinical Research Section, Shanghai Research Institute of Acupuncture and Meridian, Shanghai Yueyang Hospital, Shanghai, China
| | - Shan Liu
- Clinical Evaluation and Analysis Center, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Shenhong Wang
- Department of Urology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Lihua Xuan
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Yunqiu Gao
- Department of Urology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
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Lu Q, Wu L, Qi L, Tie P, Guan Z. Effect of Comprehensive Care Based on Appropriate Chinese Medicine Techniques on Urinary Retention and Bladder Function Recovery after Total Hysterectomy in Patients with Cervical Cancer. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7495418. [PMID: 35813441 PMCID: PMC9262532 DOI: 10.1155/2022/7495418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/02/2022] [Accepted: 06/08/2022] [Indexed: 11/17/2022]
Abstract
Objective To investigate the effect of comprehensive care based on appropriate Chinese medicine techniques on urinary retention and bladder function recovery after total hysterectomy in patients with cervical cancer. Methods A total of 148 cases admitted after radical hysterectomy for cervical cancer from January 2019 to early September 2019 were used as the observation sample and were divided into control and experimental groups based on a randomized double-blind method. There were 74 cases each. The control group was given comprehensive care, and the experimental group was given comprehensive care based on appropriate Chinese medicine techniques. The intervention period was 2 weeks after surgery. The recovery rate of bladder function and the occurrence of urinary retention were compared between the two groups, and the duration of postoperative retention of urinary catheter, the amount of residual urine, and the feeling of urination were counted. Results The experimental group had better urinary catheter retention time, time to first spontaneous voiding, time to get out of bed, and time to anal discharge than the control group; the experimental group had a higher rate of good bladder function recovery than the control group and better bladder recovery time, residual urine volume, and incidence of urinary retention than the control group; the patients in the experimental group had better UDI-6 scores. Conclusion The implementation of comprehensive care based on appropriate Chinese medicine techniques can relieve patients' difficulty in urination and improve their quality of life.
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Affiliation(s)
- Qing Lu
- Jiangsu Cancer Hospital, China
- Jiangsu Institute of Cancer Disease Prevention and Control, China
- Affiliated Cancer Hospital of Nanjing Medical University, China
| | - LiangHong Wu
- Jiangsu Cancer Hospital, China
- Jiangsu Institute of Cancer Disease Prevention and Control, China
- Affiliated Cancer Hospital of Nanjing Medical University, China
| | - LiYing Qi
- Jiangsu Cancer Hospital, China
- Jiangsu Institute of Cancer Disease Prevention and Control, China
- Affiliated Cancer Hospital of Nanjing Medical University, China
| | - Ping Tie
- Jiangsu Cancer Hospital, China
- Jiangsu Institute of Cancer Disease Prevention and Control, China
- Affiliated Cancer Hospital of Nanjing Medical University, China
| | - Zhihong Guan
- Jiangsu Cancer Hospital, China
- Jiangsu Institute of Cancer Disease Prevention and Control, China
- Affiliated Cancer Hospital of Nanjing Medical University, China
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Veshnavei HA. Urinary incontinency after radical prostatectomy and effects of 1 month pre-operative biofeedback training. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL UROLOGY 2021; 9:489-496. [PMID: 34993268 PMCID: PMC8727787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Radical prostatectomy is one of the treatment choices in patients with prostate cancer. Urinary incontinency is a common complication of this surgery that could significantly influence on the quality of life (QOL) in patients. In the present study, we aimed to investigate the effects of pre-operative biofeedback training on this issue. METHODS This is a randomized controlled clinical trial that was performed in 2017-2021 on 240 patients that were candidates for radical prostatectomy. The demographic data of all patients including age and gender were collected. The patients were randomized into two groups each containing 120 patients. The first group of patients were visited by an experienced physiotherapist and he instructed them in pelvic floor muscle training (Kegel training) using biofeedback technique in a one-hour-long training class for one month before their surgery. The other group received no pelvic floor muscle training instructions. Presence of urinary incontinence was asked from all patients 24 hours, one week, one month, three months and six months after removal of the patients' urinary catheter. We used International Consultation on Incontinence Questionnaire Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) long-form questionnaire to obtain data regarding urinary incontinence. By the means of this questionnaire, we evaluated patient's QOL. RESULTS The QOL of patients in the intervention group was significantly higher within 1 day, 1 week, 1 month and 3 months after the surgical operations compared to the control group (P<0.05). No significant differences were observed between groups at the 6 months after the surgeries (P>0.05). CONCLUSION Biofeedback has significant short-term effects on the urinary incontinence immediately after the surgical operation. We also observed that biofeedback had no significant long-term effects.
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Terzoni S, Ferrara P, Bellati G, Mora C, Pinna H, Borelli S, Destrebecq A. Maintenance exercises for urinary continence after rehabilitation following radical prostatectomy: Follow‐up study. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2021. [DOI: 10.1111/ijun.12299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Stefano Terzoni
- San Paolo Bachelor School of Nursing San Paolo Teaching Hospital Milan Italy
| | - Paolo Ferrara
- San Paolo Bachelor School of Nursing San Paolo Teaching Hospital Milan Italy
| | | | - Cristina Mora
- Urology Outpatients Service San Paolo Teaching Hospital Milan Italy
| | - Helené Pinna
- ASST Santi Paolo e Carlo, San Paolo teaching hospital Milan Italy
| | - Silvia Borelli
- European Institute of Oncology, Gynaecology Oncology unit Milan Italy
| | - Anne Destrebecq
- University of Milan, Department of Biomedical Sciences for Health Milan Italy
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Villa G, Galli E, Azzimonti V, Doneda M, Giannetta N, Manara DF. Empowerment-Based Education in Urological Patients: A Scoping Review. Clin Nurs Res 2021; 31:666-689. [PMID: 34323106 DOI: 10.1177/10547738211030389] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Prostate, kidney, and bladder cancer are the three most frequently diagnosed urological cancers. Educational programs could teach patients to become experts in disease management. The aim of this scoping review was to explore the literature to identify the educational requirements and strategies for improving and implementing educational processes for urological patients undergoing surgery. We searched several databases, including PubMed, CINAHL, Embase, Scopus, PsycINFO, and Cochrane Library. All adult patients undergoing urological educational interventions were included in the review. Of 3,197 initially identified articles, 42 were retained. Urological patients undergoing prostatectomy, cystectomy, and nephrectomy require cognitive, psychological, and functional support. For each level of support, several methods exist to provide support, including informational brochures, preoperative counseling, telephone support, online content, educational videos, support groups, individual stress management interventions, peer support, online interventions, partner support, and various educational programs that help the patient manage negative effects associated with the urological intervention.
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Affiliation(s)
- Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University of Milan, Lombardia, Italy
| | - Emanuele Galli
- Nursing School San Raffaele Hospital, Vita-Salute San Raffaele University of Milan, Lombardia, Italy.,IRCSS San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | | | - Marianna Doneda
- IRCSS San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Noemi Giannetta
- Vita-Salute San Raffaele University of Milan, Lombardia, Italy
| | - Duilio Fiorenzo Manara
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University of Milan, Lombardia, Italy
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12
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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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13
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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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Jacomo RH, Nascimento TR, Lucena da Siva M, Salata MC, Alves AT, da Cruz PRC, Batista de Sousa J. Exercise regimens other than pelvic floor muscle training cannot increase pelvic muscle strength-a systematic review. J Bodyw Mov Ther 2020; 24:568-574. [PMID: 33218562 DOI: 10.1016/j.jbmt.2020.08.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/15/2020] [Accepted: 08/28/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Although pelvic floor muscle training is widely recommendedin the literature as the gold standard for the treatment of pelvic floor dysfunctions, such as urinary incontinence, interest in other exercise regimens is increasing. However, it is unknown whether other exercise regimens increase pelvic floor muscle strength. METHODS This was a systematic review of randomized clinical trials found in PEDro, tridatabase, Cochrane and PubMed on the efficacy of nonspecific exercises, such as Pilates, the Paula method, and hypopressive exercises, in strengthening pelvic floor muscles in adults without underlying neurological disorders and with or without pelvic floor dysfunction. RESULTS Seven studies were analyzed, and the results demonstrated that Pilates, the Paula method, and hypopressive exercises are ineffective in increasing pelvic muscle strength unless they are performed in conjunction with pelvic floor muscle training. The protocol was registered in the PROSPERO database (www.crd.york.ac.uk/prospero/) under the number CRD42019123396. CONCLUSION Considering the available studies, we have concluded that Pilates, the Paula method and hypopressive exercises performed alone do not increase pelvic floor muscle strength. Pelvic floor muscle training continues to be the gold standard for increasing pelvic muscle strength.
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Affiliation(s)
- Raquel Henriques Jacomo
- Hospital Universitário de Brasília, Unidade de Reabilitação, Serviço de Fisioterapia Uroginecológica SGAN 605, Av. L2 Norte, Zip-code: 70.840-901, Brasília, DF, Brazil.
| | - Tatiana Reis Nascimento
- Universidade de Brasília, Departamento de Fisioterapia, Centro Metropolitano, Conjunto A, lote 01, Campus Ceilândia, Zip-code: 72220-90, Brasília, DF, Brazil.
| | - Marianne Lucena da Siva
- Universidade Federal de Jataí, Departamento de Fisioterapia, BR 364, km 195 no 3800, Zip-code: 75801-615, Jataí, GO, Brazil.
| | - Mariana Cecchi Salata
- Centro Universitário do Planalto Central Aparecido dos Santos UNICEPLAC, SIGA, Área especial n2 Setor Leste do Gama. Zip-code: 72445-020.
| | - Aline Teixeira Alves
- Universidade de Brasília, Departamento de Fisioterapia, Centro Metropolitano, Conjunto A, lote 01, Campus Ceilândia, Zip-code: 72220-90, Brasília, DF, Brazil.
| | - Pedro Rincon Cintra da Cruz
- Hospital Universitário de Brasília, Unidade de Urologia, Hospital Universitário de Brasília SGAN 605, Av. L2 Norte, Zip-code: 70.840-901, Brasília, DF, Brazil . Hospital de Base do Distrito Federal, Departamento de Urologia. SMHS Area Especial Quadra 101, Zip-code: 70335-900.
| | - João Batista de Sousa
- Universidade de Brasília. Faculdade de Medicina. Programa de Ciências Médicas. Campus Darcy Ribeiro, Asa-Norte Zip-code: 70910-900, Brasília, DF, Brazil.
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Feng D, Liu S, Li D, Han P, Wei W. Analysis of conventional versus advanced pelvic floor muscle training in the management of urinary incontinence after radical prostatectomy: a systematic review and meta-analysis of randomized controlled trials. Transl Androl Urol 2020; 9:2031-2045. [PMID: 33209667 PMCID: PMC7658159 DOI: 10.21037/tau-20-615] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background The underutilization of additional supportive muscles is one of the potential reasons for suboptimal efficacy of conventional pelvic floor muscle training (CPFMT). The present study concentrates on any advantage of advanced pelvic floor muscle training (APFMT) in patients with urinary incontinence (UI) after radical prostatectomy (RP). Methods Literature search was conducted on PubMed, Embase, Cochrane Library and Web of Science from database inception to February 2020. The data analysis was performed by the Cochrane Collaboration's software RevMan 5.3. Results Both APFMT and CPFMT groups indicates superiority over baseline in terms of pad number, the International Consultation on Incontinence Questionnaire—Short Form (ICIQ-SF) score, pad weight at short-term follow-up, and PFME and PFMS at intermediate-term follow-up. No adverse events were reported in all included studies. Patients receiving APFMT had a similar attrition rate to those receiving CPFMT (18/236 vs. 22/282, P=0.61). Compared to CPFMT group, APFMT group provided intermediate-term advantages in terms of pad number (MD: −0.75, 95% CI: −1.36 to −0.14; P=0.02), ICIQ-SF score (MD: −3.79, 95% CI: −5.89 to −1.69; P=0.0004), PFME (MD: 1.93, 95% CI: 0.99 to 2.87; P<0.0001) and pad weight (MD: −1.40, 95% CI: −1.70 to −1.00; P<0.00001). Conclusions Current evidence indicated that APFMT might facilitate the recovery of UI after RP according to intermediate-term advantages over CPFMT in terms of pad number, ICIQ-SF score, PFME and pad weight. Further standardized, physiotherapist-guided and well-designed clinical trials conducted by large multicenter and experienced multidisciplinary clinicians are still warranted.
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Affiliation(s)
- Dechao Feng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Shengzhuo Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Dengxiong Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Ping Han
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Wuran Wei
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
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Rial Rebullido T, Chulvi-Medrano I, Faigenbaum AD, Stracciolini A. Pelvic Floor Dysfunction in Female Athletes. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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The Efficacy of the WeChat App Combined with Pelvic Floor Muscle Exercise for the Urinary Incontinence after Radical Prostatectomy. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6947839. [PMID: 32258138 PMCID: PMC7109580 DOI: 10.1155/2020/6947839] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 11/12/2019] [Indexed: 11/30/2022]
Abstract
Objective This research is aimed at studying the effect of the WeChat app combined with pelvic floor muscle exercise (PFME) on urinary incontinence (UI) for patients treated with radical prostatectomy (RP). Patients and Methods. We retrospectively reviewed 112 patients who not only had done open RP or laparoscopic RP in our institution but also had sufficient data: preoperative information and more than one year of follow-up records. All the patients received instructions in correct pelvic floor muscle contraction and were encouraged to train the pelvic floor muscle. 58 patients, who were offered additional training guide by the WeChat app after hospital, were divided into group A, while the other 54 patients, who did PFME alone after hospital, were divided into group B. All the patients underwent a 24 h pad test at 3 days, 1 month, 3 months, 6 months, and 12 months after catheter removal. The differences in preoperative information and the results of the 24 h pad test in the follow-up, from the two groups of patients, were compared statistically. And we defined “urinary continence” as 0 g at a 24 h pad test. Results No statistically significant difference in background variable in patients of group A and group B was found. On a 24 h pad test (g), group A had better results compared to group B: 254 ± 76 vs 293 ± 86 (1 month, p < 0.05), 76 ± 47 vs 98 ± 58 (3 months, p < 0.05), 76 ± 47 vs 98 ± 58 (3 months, p < 0.05), 76 ± 47 vs 98 ± 58 (3 months, p < 0.05), 76 ± 47 vs 98 ± 58 (3 months, p < 0.05), 76 ± 47 vs 98 ± 58 (3 months, p < 0.05), 76 ± 47 vs 98 ± 58 (3 months, Conclusion Compared to doing PFME alone, the WeChat app combined with pelvic floor muscle training can decrease urine leakage and increase the number of urinary continence after radical prostatectomy.
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18
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ElDeeb AM, Abd-Ghafar KS, Ayad WA, Sabbour AA. Effect of segmental stabilizing exercises augmented by pelvic floor muscles training on women with postpartum pelvic girdle pain: A randomized controlled trial. J Back Musculoskelet Rehabil 2020; 32:693-700. [PMID: 30636728 DOI: 10.3233/bmr-181258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Pelvic girdle pain (PGP) is a significant problem that affects daily living activities in postpartum women. OBJECTIVE This study aimed to investigate the effect of stabilizing exercises with or without pelvic floor muscles (PFM) training on pain, functional disability, trunk range of motion (ROM) and PFM strength in women with PGP. METHODS Forty postpartum women participated in the study. Their age ranged from 25-35 years and their body mass index (BMI) was 25-29.9 kg/m2. They were randomly assigned into two groups equal in number. Group (A) received local stabilizing exercises, while group (B) received stabilizing exercises and PFM training. Pain, functional disability, trunk ROM and PFM strength have been evaluated using visual analogue scale (VAS), Oswestry Disability Index (ODI), Schober test and Kegel periniometer respectively. RESULTS Both groups (A and B) revealed a significant decrease (p= 0.001) in pain and functional disability and a significant increase (p= 0.001) in trunk ROM and PFM strength. However, group (B) showed a significant decrease (p= 0.001) in pain, and functional disability and a significant increase in PFM strength when compared with group (A). CONCLUSIONS PFM training should be an essential part in rehabilitation programs of PGP postpartum.
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Affiliation(s)
- Abeer M ElDeeb
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Dokki, Giza, Egypt
| | - Khaled S Abd-Ghafar
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Dokki, Giza, Egypt
| | - Waled A Ayad
- Department of Gynecology and Obstetrics, Faculty of Medicine, Al-Azhr University, Nasr City, Cairo, Egypt
| | - Adly A Sabbour
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Dokki, Giza, Egypt
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Sodré DSM, Sodré PRS, Brasil C, Teles A, Dória M, Café LE, Lordelo P. New concept for treating urinary incontinence after radical prostatectomy with radiofrequency: phase 1 clinical trial. Lasers Med Sci 2019; 34:1865-1871. [PMID: 30989457 DOI: 10.1007/s10103-019-02784-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/02/2019] [Indexed: 02/05/2023]
Abstract
To describe the clinical response and side effects of radiofrequency treatment in patients with urinary incontinence after radical prostatectomy. This is a phase 1 clinical trial with 10 men up to 65 years of age who had urinary incontinence after radical prostatectomy, post void residual volume < 50 ml verified by ultrasonography, pad test ≥ 1 g, and PSA < 0.2 ng/ml. pad test and self-administered questionnaires were used to assess clinical response. Scales were used to measure treatment satisfaction and improvement in symptoms. Participants underwent five sessions of 2 min of non-ablative endoanal radiofrequency (41 °C). The evaluated co-primary endpoints were urinary incontinence volume and urinary symptoms, analyzed by the Wilcoxon nonparametric test; residual volume, and self-reports to assess safety. The participants' mean age was 57.5 ± 4.9. The initial pad test score was 6.5 g (1.7-50.0) with a final score of 2.0 g (0.0-9.0) (p < 0.01). Ultrasonography showed no alteration of residual volume. A decrease of urinary loss was found in nine patients, three of them showed a complete resolution of urinary loss. A decrease in irritative micturition symptoms was found as well, but no improvement in the quality of life was shown. Regarding treatment satisfaction, two patients were neutral, six satisfied, and two very satisfied. Limitations included pain while the endoanal electrode was inserted. Four patients indicated pain during treatment, but overall results were positive. The reduction of urinary loss and irritative micturition symptoms increased patients' satisfaction scores, without improving their perception of quality of life.
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Affiliation(s)
- Danielle Santana Macêdo Sodré
- Bahiana School of Medicine and Public Health, Av. Dom Joao VI, 275, Brotas, Salvador, Bahia, 40290-000, Brazil
- Center for Care of Pelvic Floor, Salvador, Bahia, Brazil
| | - Plínio Roberto Souza Sodré
- Center for Care of Pelvic Floor, Salvador, Bahia, Brazil
- University of State of Bahia (UNEB), Salvador, Brazil
| | - Cristina Brasil
- Bahiana School of Medicine and Public Health, Av. Dom Joao VI, 275, Brotas, Salvador, Bahia, 40290-000, Brazil
- Center for Care of Pelvic Floor, Salvador, Bahia, Brazil
| | - Alcina Teles
- Center for Care of Pelvic Floor, Salvador, Bahia, Brazil
| | - Matheus Dória
- Bahiana School of Medicine and Public Health, Av. Dom Joao VI, 275, Brotas, Salvador, Bahia, 40290-000, Brazil
- Center for Care of Pelvic Floor, Salvador, Bahia, Brazil
| | - Luiz Eduardo Café
- Bahiana School of Medicine and Public Health, Av. Dom Joao VI, 275, Brotas, Salvador, Bahia, 40290-000, Brazil
| | - Patrícia Lordelo
- Bahiana School of Medicine and Public Health, Av. Dom Joao VI, 275, Brotas, Salvador, Bahia, 40290-000, Brazil.
- Center for Care of Pelvic Floor, Salvador, Bahia, Brazil.
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Au D, Matthew AG, Alibhai SM, Jones JM, Fleshner NE, Finelli A, Elterman D, Singal RK, Jamnicky L, Faghani N, Hilton WJ, Auger LE, Ritvo P, Trachtenberg J, Santa Mina D. Pfilates and Hypopressives for the Treatment of Urinary Incontinence After Radical Prostatectomy: Results of a Feasibility Randomized Controlled Trial. PM R 2019; 12:55-63. [DOI: 10.1002/pmrj.12157] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 02/22/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Darren Au
- Faculty of Kinesiology and Physical EducationUniversity of TorontoTorontoCanada
- Cancer Rehabilitation and SurvivorshipUniversity Health NetworkTorontoCanada
| | - Andrew G. Matthew
- Department of MedicineUniversity of TorontoTorontoCanada
- Department of UrologyUniversity Health NetworkTorontoCanada
- Department of SurgeryUniversity of TorontoTorontoCanada
| | | | - Jennifer M. Jones
- Cancer Rehabilitation and SurvivorshipUniversity Health NetworkTorontoCanada
- Department of MedicineUniversity of TorontoTorontoCanada
| | - Neil E. Fleshner
- Department of MedicineUniversity of TorontoTorontoCanada
- Department of UrologyUniversity Health NetworkTorontoCanada
- Department of SurgeryUniversity of TorontoTorontoCanada
| | - Antonio Finelli
- Department of MedicineUniversity of TorontoTorontoCanada
- Department of UrologyUniversity Health NetworkTorontoCanada
- Department of SurgeryUniversity of TorontoTorontoCanada
| | - Dean Elterman
- Department of MedicineUniversity of TorontoTorontoCanada
- Department of UrologyUniversity Health NetworkTorontoCanada
- Department of SurgeryUniversity of TorontoTorontoCanada
| | - Rajiv K. Singal
- Department of SurgeryUniversity of TorontoTorontoCanada
- Department of SurgeryMichael Garron HospitalTorontoCanada
| | - Leah Jamnicky
- Department of UrologyUniversity Health NetworkTorontoCanada
| | | | - William J. Hilton
- Cancer Rehabilitation and SurvivorshipUniversity Health NetworkTorontoCanada
| | - Leslie E. Auger
- Cancer Rehabilitation and SurvivorshipUniversity Health NetworkTorontoCanada
- Faculty of KinesiologyUniversity of Guelph‐HumberTorontoCanada
| | | | - John Trachtenberg
- Department of MedicineUniversity of TorontoTorontoCanada
- Department of UrologyUniversity Health NetworkTorontoCanada
- Department of SurgeryUniversity of TorontoTorontoCanada
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical EducationUniversity of TorontoTorontoCanada
- Cancer Rehabilitation and SurvivorshipUniversity Health NetworkTorontoCanada
- Department of MedicineUniversity of TorontoTorontoCanada
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Dierick F, Galtsova E, Lauer C, Buisseret F, Bouché AF, Martin L. Clinical and MRI changes of puborectalis and iliococcygeus after a short period of intensive pelvic floor muscles training with or without instrumentation : A prospective randomized controlled trial. Eur J Appl Physiol 2018; 118:1661-1671. [PMID: 29948199 DOI: 10.1007/s00421-018-3899-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 05/22/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE This study evaluates the impact of a 3-week period of intensive pelvic floor muscles training (PFMT), with or without instrumentation, on clinical and static magnetic resonance imaging (MRI) changes of puborectalis (PR) and iliococcygeus (IL) muscles. METHODS 24 healthy young women were enrolled in the study and 17 achieved the 9 sessions of 30 min training exercises and conducted all assessments. Participants were randomly assigned in two training groups: voluntary contractions combined with hypopressive exercises (HYPO) or biofeedback exercises combined with transvaginal electrical stimulations (ELEC). Clinical and T2-weighted MRI assessments were realized before and after training. RESULTS Modified Oxford Grading System (MOGS) scores for left PR and perineal body significantly increased in the two groups (p = 0.039, p = 0.008), but MOGS score for right PR significantly increased only in HYPO (p = 0.020). Muscle volumes of right and left IL significantly decreased (p = 0.040, p = 0.045) after training as well as signal intensities of right and left PR (p = 0.040, p = 0.021) and thickness of right and left IL at mid-vagina location (p = 0.012, p = 0.011). CONCLUSIONS A short period of intensive PFMT induces clinical and morphological changes in PFMs at rest suggesting a decrease in IL volume and adipose content of PR. Although the results suggested that an intensive non-instrumented PFMT is as effective as an instrumented training, future controlled studies with greater sample sizes are needed to establish the relative and absolute effectiveness of each of the two interventions.
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Affiliation(s)
- Frédéric Dierick
- Forme and Fonctionnement Humain Lab, Department of Physical Therapy, CERISIC, Haute Ecole Louvain en Hainaut, rue Trieu Kaisin, 136, 6061, Montignies-sur-Sambre, Belgium.
| | - Ekaterina Galtsova
- Forme and Fonctionnement Humain Lab, Department of Physical Therapy, CERISIC, Haute Ecole Louvain en Hainaut, rue Trieu Kaisin, 136, 6061, Montignies-sur-Sambre, Belgium
| | - Clara Lauer
- Forme and Fonctionnement Humain Lab, Department of Physical Therapy, CERISIC, Haute Ecole Louvain en Hainaut, rue Trieu Kaisin, 136, 6061, Montignies-sur-Sambre, Belgium
| | - Fabien Buisseret
- Forme and Fonctionnement Humain Lab, Department of Physical Therapy, CERISIC, Haute Ecole Louvain en Hainaut, rue Trieu Kaisin, 136, 6061, Montignies-sur-Sambre, Belgium
| | | | - Laurent Martin
- Grand Hôpital de Charleroi, site Saint-Jospeh, rue Marguerite Depasse, 6, 6060, Gilly, Belgium
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Hall LM, Aljuraifani R, Hodges PW. Design of programs to train pelvic floor muscles in men with urinary dysfunction: Systematic review. Neurourol Urodyn 2018; 37:2053-2087. [PMID: 29687914 DOI: 10.1002/nau.23593] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/23/2018] [Indexed: 01/01/2023]
Abstract
AIMS Pelvic floor muscle training (PFMT) is a first line conservative treatment for men with urinary dysfunction, but reports of its efficacy are variable. This study aimed to systematically review the content of PFMT programs used for urinary dysfunction in men. METHODS Electronic databases (PubMed, CINAHL, EMBASE, Cochrane, PEDro) were searched for studies that used PFMT in the treatment of adult men with urinary dysfunction. Details of PFMT treatment sessions and home exercise protocols were extracted. Criteria specific to PFMT were developed, based on the Consensus on Exercise Reporting Template, and applied to all studies to measure the comprehensiveness of the PFMT description in the manuscript. RESULTS Results from the 108 included studies indicate substantial heterogeneity in both the content of PFMT and the quality of reporting of the components of the exercise regimes. There was notable disparity in the muscles targeted by the interventions (and few focused on urethral control despite the use in management of urinary conditions) and the intensity of the programs (eg, 18-240 contractions per day). Most studies were missing key details of description of the PFMT programs (eg, the position in which the pelvic floor muscle [PFM] contraction was taught and how it was assessed, methods used to ensure exercise adherence). CONCLUSIONS Variation in content of PFMT programs is likely to contribute to variation in the reported efficacy for management of urinary dysfunction in men, and unclear description of the details of the evaluated programs makes it difficult to identify the effective/ineffective components. PROSPERO registration number CRD42017071038.
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Affiliation(s)
- Leanne M Hall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Rafeef Aljuraifani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Paul W Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Elliott S, Matthew A. Sexual Recovery Following Prostate Cancer: Recommendations From 2 Established Canadian Sexual Rehabilitation Clinics. Sex Med Rev 2017; 6:279-294. [PMID: 29199096 DOI: 10.1016/j.sxmr.2017.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 09/12/2017] [Accepted: 09/23/2017] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Supportive sexual health care is much-needed adjuvant care to oncologic management for men with prostate cancer (PCa). AIM To inspire the initiation of biopsychosocial sexual health programming where it does not exist and to inform program enhancement in existing sexual rehabilitation clinics (SRCs). METHODS This article reviews the combined 30-year experience of 2 well-established Canadian SRCs for men and their partners after PCa treatments, interwoven with empirical evidence. MAIN OUTCOME MEASURE To comprehensively review the biopsychosocial approach to sexual health assessment of men with PCa and their partners to direct the practicalities of running a successful and sustainable SRC. RESULTS A full description of the biomedical and psychosocial approaches, inclusive of comprehensive sexual function, the penile rehabilitation controversy, and other medical and relationship issues affecting sexual adjustment, is provided to highlight the relevance of proper assessment and follow-through for sexual adaptation and adjustment. 10 recommendations for a successful SRC are discussed, including the principles behind developing a sustainable business plan, staff acquisition and training, budget, integration of treatment and research priorities, respectful and multidisciplinary approaches to care, and suggestions of visit formats, protocols, and questionnaires. We recommend a phased approach of an SRC into usual care with the option to provide accessible and equitable care to patients not within proximal access of treating institutions. CONCLUSION Sexual rehabilitation after treatment for PCa requires a complex treatment process. Providing sustainable sexual rehabilitation programming under the financially strained environment of the Canadian medical system is a challenge; therefore, to provide Canadian patients and their partners with comprehensive cancer care, they deserve a biopsychosocial approach combined with a creative and systematic implementation strategy. Elliott S, Matthew A. Sexual Recovery Following Prostate Cancer: Recommendations From 2 Established Canadian Sexual Rehabilitation Clinics. Sex Med Rev 2018;6:279-294.
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Affiliation(s)
- Stacy Elliott
- Prostate Cancer Supportive Care Program, Prostate Center, Vancouver Hospital, Department of Urological Sciences, University of British Columbia, Vancouver, BC, Canada; BC Center for Sexual Medicine, Vancouver Coastal Health Authority, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
| | - Andrew Matthew
- Cancer Clinical Research Unit, Princess Margaret Cancer Centre, University Health Network, Department of Surgery (Division of Urology) and Psychiatry, University of Toronto, Toronto, ON, Canada
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Gomes CS, Pedriali FR, Urbano MR, Moreira EH, Averbeck MA, Almeida SHM. The effects of Pilates method on pelvic floor muscle strength in patients with post-prostatectomy urinary incontinence: A randomized clinical trial. Neurourol Urodyn 2017; 37:346-353. [PMID: 28464434 DOI: 10.1002/nau.23300] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 03/17/2017] [Indexed: 11/08/2022]
Abstract
AIMS To assess the effects of a Pilates exercise program compared to conventional pelvic floor muscle training (PFMT) protocol on pelvic floor muscle strength (PFMS) in patients with post-prostatectomy urinary incontinence. METHODS Patients were randomized into three treatment groups (G1: Pilates, G2: electrical stimulation combined with PFMT, and G3: control group). Duration of therapy was 10 weeks. Baseline assessment included the 24 h pad-test and the ICI-Q questionnaire. PFMS was measured using a manometric perineometry device at baseline and 4 months after radical prostatectomy (RP). The level of significance was P < 0.05. RESULTS One hundred twenty three patients were randomized and 104 patients completed the study protocol (G1: n = 34; G2: n = 35; G3: n = 35). Post-treatment assessment showed statistically significant improvements in maximum strength in G2, increased endurance in G1 and G2, and increment of muscle power in all three groups (P < 0.05). However, there were no significant differences in the mean changes of maximum strength, endurance, and muscle power between groups after treatment (P > 0.05). G1 and G2 achieved a higher number of fully continent patients than G3 (P < 0.05). At the end of treatment, 59% of patients in G1, 54% in G2, and 26% in G3 were continent (no pads/day). CONCLUSIONS Improvements in PFMS parameters were distinct among active treatment groups versus controls, but did not predict recovery of urinary continence at final assessment. The Pilates method promoted similar outcomes in the proportion of fully continent patients when compared to conventional PFMT 4 months after RP.
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Affiliation(s)
- Cíntia S Gomes
- Physiotherapist, State University of Londrina, Londrina, Brazil
| | | | - Mariana R Urbano
- Statistics Department, State University of Londrina, Londrina, Brazil
| | - Eliane H Moreira
- Physiotherapy Department, Center for Health Sciences, State University of Londrina, Londrina, Brazil
| | - Marcio A Averbeck
- Department of Urology, Video Urodynamics Unit, Moinhos de Vento Hospital, Porto Alegre, Brazil
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