Effects of perioperative pelvic floor muscle training on early recovery of urinary continence and erectile function in men undergoing radical prostatectomy: a randomized clinical trial

ABSTRACT Aims: Radical prostatectomy (RP) can result in urinary incontinence (UI) and erectile dysfunction (ED), which negatively impact quality of life (QoL). This study aimed to evaluate the effects of a perioperative pelvic floor muscle training (PFMT) program versus usual care on early recovery of urinary continence and erectile function after RP. Materials and Methods: Of 59 eligible men, 31 were randomly allocated into 2 groups: Group 1 (Control, N=15) received usual post-RP care; and Group 2 (Physical therapy, N=16) received two pre-RP physical therapist-guided PFMT sessions, including exercises and electromyographic biofeedback, and verbal and written instructions to continue PFMT until RP, which was then resumed after urethral catheter removal. The International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire were used to evaluate UI and ED, respectively. Results: Demographic characteristics were similar in both groups. Three months after RP, the UI rate was 72.7% and 70.0% in Groups 1 and 2, respectively (P >0.05). The severity and frequency of UI and its impact on QoL were evaluated by the ICIQ-Short Form, with scores of 6.9±6.26 in Group 1 and 7.0±5.12 in Group 2 (P >0.05). The IIEF-5 scores were similar in Groups 1 and 2 (5.73±7.43 vs. 6.70±6.68, respectively) (P >0.05). Conclusion: Our pre-RP protocol of two physical therapist-assisted sessions of PFMT plus instructions did not significantly improve urinary continence or erectile function at 3 months after RP.

摘要 研究目的：根治性前列腺切除术（Radical Prostatectomy, RP）可引发尿失禁（Urinary Incontinence, UI）与勃起功能障碍（Erectile Dysfunction, ED），对患者生活质量（Quality of Life, QoL）造成负面影响。本研究旨在评估围手术期盆底肌训练（Perioperative Pelvic Floor Muscle Training, PFMT）方案相较于常规护理，对根治性前列腺切除术后尿控与勃起功能早期恢复的影响。材料与方法：本研究纳入59名符合入组标准的男性患者，其中31名被随机分为两组：第1组（对照组，N=15）接受常规前列腺切除术后护理；第2组（物理治疗组，N=16）接受2次由物理治疗师指导的术前盆底肌训练，包括训练动作与肌电图生物反馈指导，并辅以口头及书面指导以要求患者在术前持续进行盆底肌训练，且在尿道导尿管拔除后恢复训练。本研究分别采用国际尿失禁咨询委员会问卷简表（International Consultation on Incontinence Questionnaire - Short Form, ICIQ-SF）与5条目版国际勃起功能指数（International Index of Erectile Function, IIEF-5）评估尿失禁与勃起功能障碍情况。结果：两组患者的人口学特征无显著差异。前列腺切除术后3个月，第1组与第2组的尿控恢复率分别为72.7%与70.0%（P>0.05）。采用ICIQ简表评估尿失禁的严重程度、发生频率及其对生活质量的影响，第1组与第2组的评分分别为6.9±6.26与7.0±5.12（P>0.05）。两组的IIEF-5评分无显著差异（分别为5.73±7.43与6.70±6.68，P>0.05）。结论：本研究中，术前由物理治疗师辅助的2次盆底肌训练联合后续指导方案，并未显著改善前列腺切除术后3个月时的尿控恢复情况与勃起功能。