Perioperative pelvic floor muscle training can hasten recovery of bladder control and reduce severity of urinary incontinence following radical prostatectomy. Nevertheless, most men undergoing prostatectomy do not receive this training. The purpose of this trial was to test the effectiveness of interactive mobile telehealth (mHealth) to deliver an evidence-based perioperative behavioral training program for post-prostatectomy incontinence.
This was a three-site, 2-arm, randomized trial (2014-2019). Men with prostate cancer scheduled to undergo radical prostatectomy were randomized to a perioperative behavioral program (education, pelvic floor muscle training, progressive exercises, bladder control techniques) or a general prostate cancer education control condition, both delivered by mHealth for 1-4 weeks preoperatively and 8 weeks postoperatively. The primary outcome was time to continence following surgery measured by the International Consultation on Incontinence Questionnaire Short-Form. Secondary outcomes measured at 6, 9 and 12 months included Urinary Incontinence Subscale of Expanded Prostate Cancer Index Composite; pad use; International Prostate Symptom Score QoL Question; and Global Perception of Improvement.
245 men (ages 42-78 years; mean=61.7) were randomized. Survival analysis using the Kaplan-Meier estimate showed no statistically significant between-group differences in time to continence. Analyses at 6 months indicated no statistically significant between-group differences in ICIQ scores (mean=7.1 vs. 7.0, p=0.7) or other secondary outcomes.
mHealth delivery of a perioperative program to reduce post-prostatectomy incontinence was not more effective than an mHealth education program. More research is needed to assess whether perioperative mHealth programs can be a helpful addition to standard prostate cancer care.
The Journal of urology. 2022 Apr 07 [Epub ahead of print]
Patricia S Goode, Theodore M Johnson, Diane K Newman, Camille P Vaughan, Katharina V Echt, Alayne D Markland, Richard Kennedy, Keith N Van Arsdalen, Soroush Rais-Bahrami, Muta M Issa, Susan Barnacastle, Kate Clark Wright, Patrick McCabe, Matthew P Malone, David T Redden, Kathryn L Burgio
Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Birmingham, Alabama and Atlanta, Georgia., University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania., Emory University School of Medicine, Atlanta, Georgia., Gastroenterology Consultants, Reno, Nevada., The University of Arkansas for Medical Sciences/Arkansas Children's Hospital, Little Rock, Arkansas.