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Systematic pelvic floor training for lower urinary tract symptoms post‐prostatectomy: a randomized clinical trial
Author(s) -
Robinson Joanne P.,
Bradway Christine W.,
Nuamah Isaac,
Pickett Mary,
McCorkle Ruth
Publication year - 2008
Publication title -
international journal of urological nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.184
H-Index - 8
eISSN - 1749-771X
pISSN - 1749-7701
DOI - 10.1111/j.1749-771x.2007.00033.x
Subject(s) - medicine , prostatectomy , lower urinary tract symptoms , quality of life (healthcare) , randomized controlled trial , international prostate symptom score , distress , pelvic floor , nocturia , urology , clinical trial , physical therapy , urinary incontinence , prostate cancer , prostate , urinary system , surgery , nursing , cancer , clinical psychology
Because the majority of prostate cancers are diagnosed in the local or regional stages, radical prostatectomy is a treatment of choice for many patients, particularly men younger than 65 years of age. However, radical prostatectomy carries a significant risk of lower urinary tract symptoms (LUTS) and may also impair quality of life. The aim of the study was to examine the effects of systematic postoperative pelvic floor training (PFT) on LUTS intensity, LUTS distress and health‐related quality of life (HRQL) at 3, 6 and 12 months following radical prostatectomy. This randomized clinical trial was guided by the Theory of Unpleasant Symptoms. All participants ( n = 126) received brief instructions for exercising pelvic floor muscles before surgery and the offer of a biofeedback evaluation session 1 month following catheter removal. The intervention group ( n = 62) received an additional 4 weeks of PFT immediately following catheter removal. Intervention and control groups both reported steady declines in the intensity and distress associated with LUTS, but no between‐group differences were found. Similarly, no between‐group differences were found in impact on HRQL; however, the pattern of HRQL impact differed by group ( p < 0·01) in the direction of greater impairment over time for the control group. LUTS intensity, LUTS distress and negative effects on HRQL decline for many radical prostatectomy patients over the first postoperative year; however, improvement does not occur in all patients. Further research is needed to improve our understanding of factors that influence development, resolution and management of LUTS following radical prostatectomy.