Urinary incontinence (UI) is an important side effect of radical prostatectomy (RP). Co‐activation of surrounding muscles via novel techniques for pelvic floor rehabilitation known as Pfilates and Hypopressives have not been compared to pelvic floor muscle exercises (PFMX) for UI.
To assess the feasibility and efficacy of isolated PFMX with and without the addition of Pfilates and Hypopressives on UI recovery following RP.
Randomized controlled trial
Participants were recruited from a community and tertiary cancer centre in Toronto, Canada
A total of 226 patients undergoing RP were assessed for eligibility. One hundred twenty‐two patients were eligible and 50 consented to participate.
Participants were randomized to either isolated PFMX (control) or PFMX plus Pfilates and Hypopressives (advanced pelvic floor exercises; APFX). PFMX participants received instructions for isolated pelvic floor contractions starting with 30 contractions per day during weeks 1‐2 up to 180/day for weeks 7‐26. The APFX group received comparable volume of exercises.
Feasibility was assessed by rates of recruitment, adverse events, and study‐arm compliance. UI and quality of life were collected 1 week prior to surgery and at 2, 6, 12, and 26 weeks after surgery.
Recruitment rate was 41%, adherence to the PFMX and APFX was greater than 70%, and no reported adverse events. Between‐group differences were observed in frequency of self‐reported 24‐hour urinary leakage (rate ratio: 0.45, 95%CI: 0.22, 0.98) and during waking hours (rate ratio: 0.43, 95%CI: 0.20, 0.91) at 26‐weeks post‐surgery favouring APFX. This study was limited by the small sample size and short follow‐up.
Pfilates and Hypopressives are feasible in men undergoing RP and preliminary data suggest potential benefit in aiding recovery of UI. Larger studies with longer follow‐up are warranted.
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