Efficacia di un programma supervisionato perioperatorio di fisioterapia del pavimento pelvico per il miglioramento del recupero della continenza dopo prostatectomia radicale: trial randomizzato controllato

Translated title of the contribution: [Autom. eng. transl.] Effectiveness of a supervised perioperative pelvic floor physiotherapy program for the improvement of continence recovery after radical prostatectomy: randomized controlled trial

Emilio Sacco, Daniele Tienforti, Francesco Marangi, Alessandro D'Addessi, Marco Racioppi, Gaetano Gulino, Francesco Pinto, Andrea Volpe, Angelo Totaro, Daniele D'Agostino, Pierfrancesco Bassi

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

[Autom. eng. transl.] aim of the work to demonstrate the efficacy of a perioperative pelvic floor physiotherapy program (Pfmt) to improve continence recovery after radical retropubic prostatectomy (PrAd). materials and methods A randomized controlled, prospective, monocentric study was planned. from November 2009 to March 2010, 32 patients (average age 66 ± 5.8 years) underwent PrAd and were randomly assigned to the treatment (t) or control (c) group and followed for at least 6 months . the group t received, the day before the PrAd and the day after the removal of the bladder catheter, a supervised training session with electromyographic biofeedback, as well as oral and written instructions regarding the Kegel exercises and a home training program for the muscles of the pelvic floor. the group c received, after the removal of the catheter, only oral and written instructions on Kegel's exercises. patients in group t after catheter removal underwent monthly follow-up visits with a single Pfmt session with biofeedback at each visit. all patients underwent standardized questionnaires: iciQ-ui, iciQ-oAb, uclA-Pci. the primary endpoint was the 6-month continence recovery rate defined by the result of the iciQ-ui score = 0. the secondary endpoints were the number of incontinence episodes and diapers used per week, evaluated through the iciQ-oAb and uclA-Pci scores. the differences between the groups were analyzed using the student's t test and the non-parametric mann-whitney test (threshold p = 0.05). continence recovery time was analyzed using Kaplan-meier survival curves. results in group t, continence was achieved by 6/16 (37.5%), 8/16 (50%) and 10/16 (62.5%) patients in the first, third and sixth month, respectively, from the catheter removal. six patients (37.5%) did not recover continence. in group c only 1 patient (6.25%) was a continent at six months; the difference with the t group was statistically significant (p <0.000). from the Kaplan-meier analysis (fig. 1) a statistically significant difference was observed in the probability of recovering the state of continence at 6 months (p = 0.0007); hazard ratio = 12.9154; 95% ci = 2.5123-32.0673). the analysis of uclA-Pci and iciQ-oAb scores showed statistically significant differences in favor of the t group at the 3-year follow-up (403.81 vs 272.44 with p = 0.006 and 10.12 vs 13.19 with p = 0.03, respectively) and at 6 months (422.50 vs 274.25 with p = 0.003 and 9.06 vs 12.62 with p = 0.01, respectively). the number of incontinence episodes per week and the number of diapers per week were lower for patients in the t group both at 3 (3.84 vs 14 and 1.50 vs 4.56, respectively) and at 6 months (2 , 72 vs 13.06 and 1.31 vs 4.12, respectively). discussion the use of a supervised but sustainable program by Pfmt significantly reduces the frequency, duration and severity of urinary incontinence in patients undergoing PrAd. concluding message Pfmt is advisable in all patients undergoing PrAd even using a predominantly home-based program.
Translated title of the contribution[Autom. eng. transl.] Effectiveness of a supervised perioperative pelvic floor physiotherapy program for the improvement of continence recovery after radical prostatectomy: randomized controlled trial
Original languageItalian
Title of host publicationLibro abstract del 84° congresso SIU
Pages208-209
Number of pages2
Publication statusPublished - 2011
Event84° CONGRESSO NAZIONALE SIU - Roma
Duration: 23 Oct 201126 Oct 2011

Conference

Conference84° CONGRESSO NAZIONALE SIU
CityRoma
Period23/10/1126/10/11

Keywords

  • FISIOTERAPIA
  • PAVIMENTO PELVICO

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