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Best Treatments For Incontinence Following Prostatectomy

August 10, 2020

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A radical prostatectomy is a common treatment option for prostate cancer in which the prostate is surgically removed. It is well known that following catheter removal after surgery, many men will experience moderate to significant amounts of involuntary urinary loss following surgery that can last from weeks to years. Hunter et al. in 2004 wrote a systematic review that found pelvic floor muscle training with a physical therapist can reduce urinary incontinence episodes by 54-72%.

In a study from 2005 (Filocamo et al.), looking at pelvic floor muscle training (PFMT) for early continence, they found that the treatment group receiving PFMT regained continence faster, with 70% continent by 3 months compared to the control group where only 30% were continent by 3 months. However, by 12 months there was no significant difference between groups.

More recently researchers are studying the effects of presurgical pelvic floor muscle training (PFMT) 5 weeks prior to a scheduled prostatectomy on rates and amount of incontinence following surgery. A recent article by Milios et al 2019, found that the control group without PFMT prior to a prostatectomy had significantly more urinary incontinence and for a longer duration after surgery than the intervention group that received PFMT.

Key takeaway: a pelvic floor muscle training program started prior to surgery can improve pelvic floor muscle function, reduces post-prostatectomy incontinence and improves quality of life measurements.

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