1344 INFLUENCE OF PREOPERATIVE PELVIC FLOOR MUSCLE STRENGTH ON POST-PROSTATECTOMY INCONTINENCE

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence - Evaluation & Therapy III1 Apr 20121344 INFLUENCE OF PREOPERATIVE PELVIC FLOOR MUSCLE STRENGTH ON POST-PROSTATECTOMY INCONTINENCE Mary H. James, Bethany B. Gibbs, Erin Glace, and Robert W. Given Mary H. JamesMary H. James Norfolk, VA More articles by this author , Bethany B. GibbsBethany B. Gibbs Norfolk, VA More articles by this author , Erin GlaceErin Glace Norfolk, VA More articles by this author , and Robert W. GivenRobert W. Given Norfolk, VA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1727AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urinary incontinence following radical prostatectomy is a significant clinical problem that compromises patient quality of life. Pelvic floor muscle training (PFMT) has been shown to reduce continence recovery time. There is currently a lack of data regarding preoperative variables that may predict which patients will have earlier return to continence. The objective of this study was to determine whether preoperative pelvic floor strength influences the degree and duration of post-prostatectomy incontinence. METHODS All patients scheduled for robotic assisted laparoscopic radical prostatectomy were referred to a certified pelvic floor physical therapist. Pelvic floor strength was assessed using EMG evaluation with perianal electrodes. Strength parameters collected included the resting, average and maximum measurements during quick and sustained contractions as well as maximum contraction during valsalva. Patients were educated and given a home training program. Chart review was performed to obtain post-operative continence data from 6 week and 3 month visits measured by reported pad per day (PPD) usage. Continence was defined in two ways: PPD=0 and PPD≤1. Baseline values for each parameter were compared in men who were continent versus not continent at each visit using independent t-tests. RESULTS Baseline data was available for 213 patients. There were 181 patients with 6 week follow-up and 170 patients with 6 week and 3 month follow-up. When defining continence as PPD=0 a higher resting tone was associated with return to continence at 6 week follow up (p=0.043) but did not hold true at 3 months. However, when defining continence as PPD≤1 a higher resting tone was associated with return to continence at the 3 month mark. (p=0.023). In this group the mean preoperative resting tone for those patients who had achieved continence was 4.5 microvolts compared to 3.4 microvolts in those patients with persistent incontinence. CONCLUSIONS Post-prostatectomy incontinence (PPI) is a common complication following radical prostatectomy that significantly affects patient quality of life. PFMT in the pre and post-operative setting has been shown to decrease the time to recovery of continence. In this study a higher pelvic floor muscle resting tone was associated improved achievement of continence at 6 weeks when defining continence as PPD=0 and at 3 months when defining continence as PPD≤1. This information could be useful for additional preoperative counseling regarding continence outcomes following prostatectomy. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e545 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mary H. James Norfolk, VA More articles by this author Bethany B. Gibbs Norfolk, VA More articles by this author Erin Glace Norfolk, VA More articles by this author Robert W. Given Norfolk, VA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...