Behavioral therapy, exercises reduce incontinence following prostate surgery
January 19, 2011
Urinary incontinence is one of the more common effects of a radical prostatectomy, but researchers have found that behavioral therapy with exercise training can reduce post-prostatectomy incontinence.
The study, reported in the Journal of the American Medical Association (JAMA), followed 208 men one year after their prostatectomy. The men were divided into three groups: one group received behavioral therapy (including pelvic floor muscle training, bladder control strategies, fluid management and bladder diaries); another received behavioral therapy plus biofeedback and pelvic floor electro-stimulation; and the third group received no extra treatment during the trial.
Both treatment groups receiving therapy reduced their incontinence episodes by half; the control group had a much smaller reduction. The benefits of the therapy were evident one year later, as incontinence episodes were still reduced by at least 50% in those two groups. However, biofeedback did not provide any additional benefits.
Though the study demonstrated the benefits of post-prostatectomy therapy, an editorial accompanying the JAMA article noted that many prostatectomies may be unnecessary, and even significant improvements in incontinence still leave much to be desired.
"Certainly, 13 episodes a week is better than the 21 episodes experienced by men in the control group, but would a patient be satisfied with approximately two daily episodes of urinary incontinence?" the editorial author wrote. "...[I]f this is as good as this therapy gets, it is important to rethink how best to treat men with this problem."
Sources: David F. Penson, M.D., MPH. "Editorial: Treatment for Postprostatectomy Incontinence: Is This as Good as It Gets?" JAMA. 2011;305(2):197-198; Patricia S. Goode et al. "Behavioral Therapy With or Without Biofeedback and Pelvic Floor Electrical Stimulation for Persistent Postprostatectomy Incontinence: A Randomized Controlled Trial." JAMA. 2011;305(2):151-159.
