An objective measurement of urinary continence recovery with pelvic floor physiotherapy following robotic assisted radical prostatectomy

To assess the impact of structured pelvic floor physiotherapy including repeated standardized measurements in regaining urinary continence in those men who have undergone a robotic-assisted laparoscopic radical prostatectomy (RALP).

A retrospective database was created on men who had undergone a RALP while under the care of two senior urological surgeons between January 2013 and July 2016 and then took part in a formal pelvic floor rehabilitation program were included in the study. Men were initially seen pre-operatively and then after removal of their indwelling catheter commenced their structured continence program. They were instructed to record their pad weights commencing at week four post-RALP. For each subsequent week, an average of the 24-hour urine leakage was recorded and compared to their first recorded week (baseline) to assess improvement of urinary continence over time.

Forty-five men with a median age of 63.7 years were followed up for a mean of 11.3 weeks post-operatively. The mean daily urine leakage during the first recorded week was 408.0 mL. This decreased to 205.8 and 110.1 mL at 2 and 3 months post-RALP (P<0.05). This equated to a significant 57.1% (95% CI, 52.9% to 61.3%) and 75.6% (95% CI, 72.3% to 78.8%) improvement in urinary leakage at the same respective time points.

There is considerable improvement of urinary leakage following RALP in the short-term in men who participated in a structured, physiotherapist-led pelvic floor re-training program.

Translational andrology and urology. 2017 Jul [Epub]

Niranjan Jude Sathianathen, Liana Johnson, Damien Bolton, Nathan L Lawrentschuk

Department of Surgical Oncology, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia., Pelvic Strength Physiotherapy, Melbourne, Australia., Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia.