The recovery of urinary continence after radical retropubic prostatectomy: a randomized trial comparing the effect of physiotherapist‐guided pelvic floor muscle exercises with guidance by an instruction folder only

• Published in: BJU international 2010-08, Vol.106 (4), p.515-522
• Main Authors: Dubbelman, Yvette, Groen, Jan, Wildhagen, Mark, Rikken, Berend, Bosch, Ruud
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Exercise Therapy; Humans; Male; Medical sciences; Middle Aged; Muscle Strength - physiology; Nephrology. Urinary tract diseases; Patient Education as Topic - methods; Pelvic Floor; pelvic floor muscle exercises; Prospective Studies; Prostatectomy - rehabilitation; Prostatic Neoplasms - surgery; radical prostatectomy; Treatment Outcome; Urinary Catheterization; urinary incontinence; Urinary Incontinence - etiology; Urinary Incontinence - rehabilitation; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2010.09159.x

Study Type – Therapy (RCT)
Level of Evidence 1b OBJECTIVE To compare the effect on the recovery of incontinence after retropubic radical prostatectomy (RRP) of intensive physiotherapist‐guided pelvic floor muscle exercises (PG‐PFME) in addition to an information folder, with PFME explained to patients by an information folder only (F‐PFME), and to determine independent predictors of failure to regain continence after RRP. PATIENTS AND METHODS We postulated that a 10% increase in the proportion of men who regained continence at 6 months with PG‐PFME compared with men treated with F‐PFME only would constitute a clinically relevant effect. To show statistical significance of this difference with a power of 80%, 96 men should be randomized to each of the two arms. One day before operation, all patients received verbal instruction and an information folder on PFME. Patients randomized to the F‐PFME arm received no further physiotherapist guidance, whereas those in the PG‐PFME arm received a maximum of nine sessions with the physiotherapist. The men underwent a 1‐h pad‐test at 1, 12 and 26 weeks, and a 24‐h pad‐test at 1, 4, 8, 12 and 26 weeks after catheter removal. We defined ‘continence’ as urine loss of