Discussion| Volume 155, P158, September 2021


  • Jerilyn M. Latini
    Address correspondence to: Jerilyn M. Latini, Department of Urology, Boston University School of Medicine, VA Boston Healthcare System, 1400 VFW Parkway, Boston, MA 02132
    Department of Urology, Boston University School of Medicine, Boston, MA
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      This is a well presented and designed randomized, controlled prospective trial of three pelvic floor strengthening regimens for men with post-prostatectomy incontinence. A total of 42 Chinese men with post-prostatectomy incontinence after either radical retropubic or laparoscopic prostatectomy underwent one of three pelvic floor strengthening regimens: Pilates training with biofeedback, Kegel training with biofeedback, or Kegel training alone. Clinical symptoms and signs were assessed before and after 8 weeks of treatment using 1 hour pad tests, number of incontinent episodes, the ICIQ The International Consultation Incontinence Questionnaire questionnaire for the subjective assessment of urinary incontinence, and the Oxford Grading Scale for determination of pelvic floor muscle strength recovery. Statistically significant differences between and within the 3 treatment groups were reported, with improvement starting after 3 weeks, and reaching a maximum benefit at 8 weeks. All and all, each of the 3 strengthening regimens were effective in the short-term, with the main limitation of this study being the lack of long-term or even moderate-term follow-up. Interestingly, the mean age of the population studied in all 3 treatment groups was more than 70 years old, suggesting that there may be as good or better results in a younger patient population. Conversely, the BMI of the population studied herein was very low. Whether men with a BMI more than 30 have comparable outcomes remains to be seen. The very low BMIs likely limits the applicability of this data. Nevertheless, the 3 pelvic floor strengthening regimens utilized in this clinical study appeared to optimize the urinary continence and pelvic floor muscle strength of men with post-prostatectomy incontinence in the short-term. This manuscript is additive to the contemporary literature on pelvic floor strengthening techniques for post-prostatectomy incontinence. This type of information is essential to survivorship clinics and the multidisciplinary teams taking care of men with post-prostatectomy incontinence.
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