Abstract
Objective
To evaluate whether pre-operative pelvic floor physical therapy (PFPT) parameters
may predict early return of urinary continence after RP. While long-term urinary continence
is eventually achieved in most patients who undergo radical prostatectomy (RP), predicting
when patients will become continent is challenging. Prior studies aiming to predict
return of post-operative continence have not evaluated patient-specific pelvic floor
strength parameters.
Methods
We reviewed a prospectively maintained database of patients undergoing RP who underwent
pre-operative PFPT consultation and completed 3-month patient-reported quality of
life evaluation. Trained therapists documented pelvic strength parameters. Urinary
continence was defined as using 0 or 1 pad per day. We evaluated the association of
PFPT parameters with urinary continence at 3 months, adjusting for other factors that
could affect continence.
Results
144 men met inclusion criteria. The majority of patients underwent nerve-sparing procedures
and had intermediate- or high-risk prostate cancer. At 3 months, 90 of 144 (62.5%)
were continent, while 54 of 144 (37.5%) were not. On multivariable analysis, prostate
volume (OR 0.98, 95% CI 0.96-1.00) and pelvic floor endurance (OR 2.71, 95% CI 1.23-6.17)
were significantly associated with being continent at 3 months. 56 of 76 (74%) men
with good pelvic floor endurance were continent at 3 months, while only 34 of 68 (50%)
men with poor endurance were continent (P = .006).
Conclusion
Pre-operative assessment of pelvic floor endurance is an objective measure that may
allow more accurate prediction of early continence after radical prostatectomy. Improved
patient counseling could positively impact patient satisfaction and quality of life
and reduce decision regret.
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Article info
Publication history
Published online: May 07, 2021
Accepted:
April 19,
2021
Received:
January 13,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
