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Incontinence Treatment After Prostate Surgery

Surgery to treat men with prostate cancer is often followed by months of difficulty controlling urine flow, a condition known as urinary incontinence. But new research suggests that this problem may go away more quickly if the men perform certain exercises to strengthen their pelvic floor muscles.

Researchers from the Kaiser Permanente Medical Center in Los Angeles, California, found that men who were taught how to perform pelvic floor exercises before and after surgery were more likely to have regained continence three months later.

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Men Doing Pelvic Exercises Recover Earlier
In the current study, the researchers randomly assigned 38 men scheduled for radical prostatectomy to either a treatment group or a control group. The men in the treatment group were referred to a physical therapist. They were instructed how to do Pelvic Floor Exercises both before and after surgery, using biofeedback to ensure they were using the proper muscles. The control group did not receive any formal instruction.

All of the men completed questionnaires regarding bladder function at regular intervals over the next year. Overall, 82% of the patients had regained continence (defined as not needing to use any absorbent pads) by the end of the year, including about equal numbers in both groups. But on average the men who had been educated about Pelvic exercises regained continence about one month earlier than those in the control group (at 12 weeks vs. 16 weeks). Most of the men who did not regain continence within a year were still using at least three absorbent pads a day, indicating continued severe incontinence.

The study authors explained that these men probably had extensive damage to the bladder sphincter or severe dysfunction of the bladder after surgery, and the exercises alone were unable to compensate for this. But the exercises seemed to be effective. Pelvic floor exercise and education initiated prior to surgery is an effective noninvasive intervention useful for improving early return of urinary continence, the authors concluded. It would certainly have a positive impact on our patients undergoing radical prostatectomy in an effort to improve quality of life after major urological surgery. The results of the study were published in the Journal of Urology (Vol. 170, No. 1: 130-133)

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