Efficacy of preoperative-guided pelvic floor exercises on urinary incontinence and quality of life after robotic radical prostatectomy.

Abstract

Introduction and objective: Radical prostatectomy has a great impact on urinary continence, although it is a multifactorial aspect. The aim of the study was to evaluate the effect of guided Pelvic Floor Exercises (PFE) versus written information prior to robotic radical prostatectomy (RRP) on the rate of urinary incontinence, and their effect on patients' quality of life.

Material and method: 62 patients were randomized to an experimental (physiotherapist-guided exercises) or control (written information) group. The primary outcome was incontinence rate (measured by pad test). Secondary outcomes were incontinence severity, quality of life (measured by the 36-Item Short Form Survey Instrument (SF-36) and the King's Health Questionnaire (KHQ)), voiding dynamics, correlation between incontinence and quality of life, and other incontinence-related factors.

Results: We found no differences in the incontinence rate between groups in the months of follow-up (82.61% vs. 84.62%, month 1; 61.54% vs. 75.86%, month 3; 50% vs. 53.33%, month 6; 30.77% vs. 40%, month 12) nor in the severity of incontinence between groups. There were significant differences in the quality of life related to "emotional problems" and "personal relationships", in favor of the control group. We found correlations between incontinence severity and age, severity and quality of life, urgency/frequency and quality of life.

Conclusions: Guided exercises prior to RRP do not seem to offer benefits over written information in either the rate or severity of incontinence. Urinary incontinence correlates with age and quality of life. Quality of life correlates with urgency and voiding frequency.