Does trunk muscle training with an oscillating rod improve urinary incontinence after radical prostatectomy? A prospective randomized controlled trial

• Published in: Clinical rehabilitation 2020-03, Vol.34 (3), p.320-333
• Main Authors: Heydenreich, Marc, Puta, Christian, Gabriel, Holger HW, Dietze, Andre, Wright, Peter, Zermann, Dirk-Henrik
• Format: Article
• Language: English
• Subjects: Aged; Cancer surgery; Clinical research; Clinical trials; Evaluative Studies; Exercise Therapy - methods; Functional assessment; Humans; Intervention; Male; Middle Aged; Oncology; Oscillation; Pelvic Floor - physiopathology; Pelvis; Physical therapy; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Prospective Studies; Prostate; Prostate cancer; Prostatectomy - adverse effects; Prostatic Neoplasms - surgery; Quality of Life; Rehabilitation; Relaxation; Surveys and Questionnaires; Treatment methods; Urinary incontinence; Urinary Incontinence - etiology; Urinary Incontinence - prevention & control; Urological surgery
• ISSN: 0269-2155; 1477-0873; 1477-0873
• DOI: 10.1177/0269215519893096

Objective: To investigate the effect of a new therapeutic approach, using an oscillating rod to strength the pelvic floor and deep abdominal musculature and to speed up recovery of continence after radical prostatectomy. Design: Prospective randomized controlled clinical trial. Setting: Inpatient uro-oncology rehabilitation clinic. Subjects: Ninety-three (intervention group (IG)) and ninety-one patients (control group (CG)) with urinary incontinence after prostatectomy were examined. Intervention: All patients were randomly allocated to either standard pelvic floor muscle exercises and oscillating rod therapy (IG) or standard pelvic floor muscle exercises and relaxation therapy (CG). Main outcome measures: Urinary incontinence (1- and 24-hour pad test) was assessed, and health-related quality of life (HRQL; Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire) was measured for all patients before and after three weeks of treatment. Results: One hundred and eighty-four patients (mean (SD) age: 64.1 (6.94) years) completed the study. The IG showed a significant reduction in urinary incontinence (1-hour pad test: P = 0.008, 24-hour pad test: P = 0.012) and a significant improvement of HRQL (P = 0.017) compared with CG. Continence was significantly improved in both groups (1-hour pad test: 22.6–8.5 g (IG) vs. 23.0–18.1 g (CG)/24-hour pad test: 242.9–126.7 g (IG) vs. 237.6–180.9 g (CG)). Conclusion: The study demonstrated that a combination of conventional continence exercises and the new oscillation rod training increased abdominal and pelvic floor musculature and speeded up recovery of continence after radical prostatectomy.