Randomized Trial Assesses Preoperative Biofeedback Assisted Behavioral Training To Decrease Incontinence In Men Undergoing Radical Prostatectomy

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Men's health
Article Date: 23 Feb 2006 - 6:00 PDT

email to a friend   printer friendly   opinions  

Most men undergoing radical prostatectomy (RP) for prostate cancer (CaP) are taught pelvic floor exercises in an unstructured fashion by their surgeon in the post-operative setting. Dr. Burgio and colleagues report the outcomes of a prospective, randomized trial of preoperative biofeedback assisted behavioral training on post RP incontinence in the January 2006 issue of the Journal of Urology.

The cohort consisted of 125 men randomized to receive either 1 preoperative biofeedback assisted behavioral training session or the usual care instructions post operatively. The behavioral training consisted of learning pelvic floor muscle control with a rectal probe in place. The probe measured rectal (abdominal) pressure and external sphincter contraction and feedback was immediately provided to the patient on how to contract the sphincter muscle while keeping the abdominal muscles relaxed.

Patients completed a questionnaire at 6 weeks, 3 months and 6 months after surgery that assessed bladder control and life-style issues. Median time to continence in the intervention group was 3.5 months. Fewer than 50% of the control group achieved continence, and therefore median time to continence could not be estimated, but was greater than 6 months. The difference in percentage of men remaining incontinent at 6 months was 20%.

Six months following RP, severe incontinence was reported in 20% of controls compared to 6% of the biofeedback patients. However, no group differences were found in life-style factors, incontinence impact or psychological distress. The differences in shorter duration of incontinence were not accompanied by a difference in the percentage of participants who returned to work or usual activities by the 6 month assessment. It is possible that the lack of effect of quality of life was due to either too small an effect of the biofeedback or that differences in incontinence were overshadowed by other issues such as cancer anxiety or sexual dysfunction.

By Christopher P. Evans, M.D.

J Urol 2006; 175:196-201
Link Here.
Burgio KL, Goode PS, Urban DA, Umlauf MG, Locher JL, Bueschen A, Redden DT

URO Today

The only urology website with original content written by global urology opinion leaders actively engaged in clinical practice.

http://www.urotoday.com

• Additional
• References
• Citations