The following is a summary of “Comparison of In-person FPMRS-directed Pelvic Floor Therapy Program Versus Unsupervised Pelvic Floor Exercises Following Prostatectomy,” published in the AUGUST 2023 issue of Urology by Rapp, et al.
For a study, researchers sought to compare comprehensive continence results in patients undergoing pelvic floor muscle training (PFMT) with those undergoing standard unsupervised home pelvic floor exercise therapy (UPFE).
Within the UVA prostatectomy functional outcomes program, patients participated in a 12-month PFMT program supervised by specialists in Female Pelvic Medicine and Reconstructive Surgery (FPMRS). A retrospective review of longitudinally collected data was performed to compare outcomes in patients undergoing PFMT and UPFE over a 12-month follow-up period. The main study outcome was the stress urinary incontinence (SUI) domain score in the ICIQ-MLUTS (International Consultation on Incontinence Questionnaire – Male Lower Urinary Tract Symptoms). Secondary outcomes encompassed daily pad use (PPD), SUI Cure (defined as SDS [SUI domain score] = 0), and the quality of life score (IIQ-7). Multilevel mixed effects linear regression was employed to model SDS over time.
The analysis included 40 men, and no major differences in patient characteristics were observed between the PFMT and UPFE cohorts. The mean predicted SDS was better in the PFMT group compared to the UPFE group at the 6-month (0.81 ± 0.21 vs. 1.75 ± 0.34, respectively) (P = .014) and 12-month (0.72 ± 0.17 vs. 1.67 ± 0.30, respectively) (P = .004) time points. At the 12-month follow-up, 11 (55%) patients in the PFMT group reported the absence of SUI, compared to 4 (20%) patients in the UPFE group. Predicted probabilities of SUI cure at 12 months were higher in the PFMT group (0.52 ± 0.14) than in the UPFE group (0.23 ± 0.13) (P = .14). At the 12-month follow-up, the mean predicted PPD and IIQ score were not different between the PFMT and UPFE groups. At 12-month follow-up, the mean predicted PPD and IIQ score was 0.19 ± 0.10 vs 0.79 ± 0.33 and 2.86 ± 0.86 vs 2.55 ± 1.07 in PFMT vs UPFE cohorts, respectively (P = NS).
Following robotic-assisted laparoscopic prostatectomy, supervised PFMT by experts in female pelvic medicine and reconstructive surgery was linked to improved SUI domain scores; the improvement persisted during the 12-month follow-up.