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BMC Urology

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01-12-2020 | Urinary Incontinence | Research article

Preoperative pelvic floor muscle exercise for early continence after holmium laser enucleation of the prostate: a randomized controlled study

Authors: Go Anan, Yasuhiro Kaiho, Hiromichi Iwamura, Jun Ito, Yuki Kohada, Jotaro Mikami, Makoto Sato

Published in: BMC Urology | Issue 1/2020

Abstract

Background

Transient postoperative urinary incontinence is a bothersome complication of holmium laser enucleation of the prostate (HoLEP). The effects of preoperative pelvic floor muscle exercise (PFME) for early recovery of continence after HoLEP have never been elucidated. The aim of this study was to determine the benefit of preoperatively started PFME for early recovery of continence after HoLEP.

Methods

We randomly assigned patients to start PFME preoperatively and continue postoperatively (group A) or start PFME no earlier than the postoperative period (group B). The primary outcome was time to complete urinary control, defined as no pad usage. The secondary outcome was measured using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score. Univariate and multivariate analyses were performed to identify parameters associated with recovery of continence after HoLEP.

Results

Seventy patients were randomized across groups A (n = 35) and B (n = 35). Patients’ characteristics were not different between groups A and B. The postoperative urinary incontinence rate significantly decreased in group A compared with that in group B at 3 months postoperatively [3% vs. 26% (P = 0.01)]. However, there were no significant differences between groups A and B at 3 days [40% vs. 54% (P = 0.34)], 1 month [37% vs. 51% (P = 0.34)], and 6 months [0% vs. 3% (P = 1.00)] postoperatively, respectively. The postoperative ICIQ-SF score was not significantly different between groups A and B at any time point postoperatively. In univariate analysis, patients who performed preoperative PFME had a 0.56-fold lower risk of urinary incontinence 1 month after HoLEP and a 0.08-fold lower risk of urinary incontinence 3 months after HoLEP.

Conclusions

Preoperatively started PFME appears to facilitate improvement of early urinary continence after HoLEP.

Trial registration

The study was registered with the University Hospital Medical Information Network Clinical Trials Registry in Japan (UMIN000034713); registration date: 31 October 2018. Retrospectively registered.

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Title: Preoperative pelvic floor muscle exercise for early continence after holmium laser enucleation of the prostate: a randomized controlled study
Authors: Go Anan
Yasuhiro Kaiho
Hiromichi Iwamura
Jun Ito
Yuki Kohada
Jotaro Mikami
Makoto Sato
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Urinary Incontinence
Benign Prostatic Hypertrophy
Prostate Surgery
Benign Prostatic Hypertrophy
Urinary Incontinence
Transurethral Prostate Resection
Laser
Published in: BMC Urology / Issue 1/2020
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/s12894-019-0570-5

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Preoperative pelvic floor muscle exercise for early continence after holmium laser enucleation of the prostate: a randomized controlled study

Abstract

Background

Methods

Results

Conclusions

Trial registration

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Abstract

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