Continence Outcome of Preoperative Pelvic Floor Muscle Training after Robotic-Assisted Laparoscopic Radical Prostatectomy: Randomized Controlled Trial

Abstract

Background: Incontinence is the second most bothersome outcome after robotic-assisted laparoscopic radical prostatectomy (RARP). Most patients will regain continence at one year, but pelvic floor muscle training (PFMT) may represent a valid treatment to improve postoperative urinary continence. Objective: To determine the relationship between preoperative PFMT functional outcomes in patients undergoing RARP. Materials and Methods: The present study was a randomized controlled trial. Sixty patients with clinically localized adenocarcinoma of the prostate between December 2020 and June 2022 were randomized into two groups: Group A included 30 patients in standard RARP and a pre-operative PFMT program, and Group B included 30 patients in which only standard RARP was performed. The primary outcome was continent status at 1, 3, and 6 months after surgery using the score from the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). The higher score means poorer incontinence status. The secondary outcomes were continence status at 1, 3, and 6 months after surgery, assessed using the pad test score. Results: The continent status at 1, 3, and 6 months postoperatively was evaluated by ICIQ-UI SF. The total mean score in Group A was better than that in Group B, but it was not statistically significant. The divided ICIQ-SF score by severity level showed a significant improvement in post-prostatectomy urinary incontinence at one month (p=0.024). Pad test at one, three, and six months for the PFMT group was better than for the control group, but was not statistically significant. Conclusion: Pre-operative PFMT for men undergoing RARP for prostate cancer may improve postoperative urinary continence.