Integrative Physical Therapy Versus Pelvic Floor Muscle Training for Post-Prostatectomy Stress Urinary Incontinence: A Randomized Controlled Trial
-
Mohammad Sheibanifar
,
Zahra Ebrahimabadi
,
Hoda Niknam
,
Farshad Okhovatian
,
Alireza Akbarzadeh Baghban
,
Marzieh Mortezanejad
Abstract
Background: Post-prostatectomy stress urinary incontinence (PPSUI) is a common complication following radical prostatectomy. This study compared the efficacy of integrative physical therapy (IPT) and supervised pelvic floor muscle training (PFMT) in managing PPSUI.
Methods: Sixty-six men aged 50–80 years with PPSUI were randomly assigned to IPT, PFMT, or control groups. The IPT program included electrotherapy, manual therapy, diaphragmatic breathing, and PFMT. The PFMT group received supervised PFMT. The control group received sham electrotherapy. All interventions were delivered in 12 sessions over four weeks. Outcome measures included voided volume, fluid intake, micturition frequency, incontinence frequency, and health-related quality of life assessed using the SF-12 questionnaire.
Results: Both IPT and PFMT significantly reduced micturition and incontinence frequency and improved SF-12 scores compared with the control group (p<0.001). The control group showed no significant improvements across any outcome measures. IPT demonstrated superior improvements relative to PFMT in micturition frequency, incontinence frequency, and SF-12 scores (p<0.05).
Conclusion: Both IPT and PFMT are effective for PPSUI, with IPT showing greater overall efficacy.
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12. Montazeri A, Vahdaninia M, Mousavi SJ, Omidvari S. The Iranian version of 12-item Short Form Health Survey (SF-12): factor structure, internal consistency and construct validity. BMC public health. 2009;9:341.
13. Ware J, Jr., Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220-33.
14. Jimenez-Cidre MA, Lopez-Fando L, Esteban-Fuertes M, Prieto-Chaparro L, Llorens-Martinez FJ, Salinas-Casado J, et al. The 3-day bladder diary is a feasible, reliable and valid tool to evaluate the lower urinary tract symptoms in women. Neurourology and urodynamics. 2015;34(2):128-32.
15. Sing Kai Lo JN, Yuelong Cao,. ADDITIVE EFFECT OF INTERFERENTIAL THERAPY OVER PELVIC FLOOR EXERCISE ALONE IN THE TREATMENT OF FEMALE URINARY STRESS AND URGE INCONTINENCE: A RANDOMIZED CONTROLLED TRIAL. Hong kong physiotherapy journal. 2003;21(1):6.
16. Strączyńska A, Weber-Rajek M, Strojek K, Piekorz Z, Styczyńska H, Goch A, et al. The Impact Of Pelvic Floor Muscle Training On Urinary Incontinence In Men After Radical Prostatectomy (RP) - A Systematic Review. Clinical interventions in aging. 2019;14:1997-2005.
17. Miller JM, Hawthorne KM, Park L, Tolbert M, Bies K, Garcia C, et al. Self-Perceived Improvement in Bladder Health After Viewing a Novel Tutorial on Knack Use: A Randomized Controlled Trial Pilot Study. J Womens Health (Larchmt). 2020;29(10):1319-27.
18. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods. 2007;39(2):175-91.
19. Centemero A, Rigatti L, Giraudo D, Lazzeri M, Lughezzani G, Zugna D, et al. Preoperative pelvic floor muscle exercise for early continence after radical prostatectomy: a randomised controlled study. European urology. 2010;57(6):1039-43.
20. Filocamo MT, Li Marzi V, Del Popolo G, Cecconi F, Marzocco M, Tosto A, et al. Effectiveness of early pelvic floor rehabilitation treatment for post-prostatectomy incontinence. European urology. 2005;48(5):734-8.
21. Yakıt Yeşilyurt S, Özengin N, Topçuoğlu MA. Comparing the efficacy of the Knack maneuver on pelvic floor muscle function and urinary symptoms using different teaching methods: a prospective, nonrandomized study. International urogynecology journal. 2022;33(10):2895-903.
22. Hinata N, Murakami G. The urethral rhabdosphincter, levator ani muscle, and perineal membrane: a review. BioMed research international. 2014;2014:906921.
23. Yu K, Bu F, Jian T, Liu Z, Hu R, Chen S, et al. Urinary incontinence rehabilitation of after radical prostatectomy: a systematic review and network meta-analysis. Frontiers in oncology. 2023;13:1307434.
2. Gacci M, De Nunzio C, Sakalis V, Rieken M, Cornu JN, Gravas S. Latest Evidence on Post-Prostatectomy Urinary Incontinence. Journal of clinical medicine. 2023;12(3).
3. Barassi G, Bellomo RG, Frondaroli F, Frondaroli S, Santarelli A, Di Felice PA, et al. Integrated Rehabilitation Approach with Manual and Mechanic-Acoustic Vibration Therapies for Urinary Incontinence. Adv Exp Med Biol. 2019;1211:41-50.
4. Dietze-Hermosa M, Hitchcock R, Nygaard IE, Shaw JM. Intra-abdominal Pressure and Pelvic Floor Health: Should We Be Thinking About This Relationship Differently? Female pelvic medicine & reconstructive surgery. 2020;26(7):409-14.
5. Wu ML, Wang CS, Xiao Q, Peng CH, Zeng TY. The therapeutic effect of pelvic floor muscle exercise on urinary incontinence after radical prostatectomy: a meta-analysis. Asian J Androl. 2019;21(2):170-6.
6. Grewar H, McLean L. The integrated continence system: a manual therapy approach to the treatment of stress urinary incontinence. Man Ther. 2008;13(5):375-86.
7. Zivkovic V, Lazovic M, Vlajkovic M, Slavkovic A, Dimitrijevic L, Stankovic I, et al. Diaphragmatic breathing exercises and pelvic floor retraining in children with dysfunctional voiding. Eur J Phys Rehabil Med. 2012;48(3):413-21.
8. Zivkovic VD, Stankovic I, Dimitrijevic L, Kocic M, Colovic H, Vlajkovic M, et al. Are Interferential Electrical Stimulation and Diaphragmatic Breathing Exercises Beneficial in Children With Bladder and Bowel Dysfunction? Urology. 2017;102:207-12.
9. Ladi-Seyedian SS, Sharifi-Rad L, Kajbafzadeh AM. Pelvic floor electrical stimulation and muscles training: a combined rehabilitative approach for management of non-neuropathic urinary incontinence in children. Journal of pediatric surgery. 2019;54(4):825-30.
10. Miller JM, Sampselle C, Ashton-Miller J, Hong GR, DeLancey JO. Clarification and confirmation of the Knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(6):773-82.
11. Chow PM, Chuang YC, Hsu KCP, Shen YC, Liu SP. Impact of Female Stress Urinary Incontinence on Quality of Life, Mental Health, Work Limitation, and Healthcare Seeking in China, Taiwan, and South Korea (LUTS Asia): Results from a Cross-Sectional, Population-Based Study. International journal of women's health. 2022;14:1871-80.
12. Montazeri A, Vahdaninia M, Mousavi SJ, Omidvari S. The Iranian version of 12-item Short Form Health Survey (SF-12): factor structure, internal consistency and construct validity. BMC public health. 2009;9:341.
13. Ware J, Jr., Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220-33.
14. Jimenez-Cidre MA, Lopez-Fando L, Esteban-Fuertes M, Prieto-Chaparro L, Llorens-Martinez FJ, Salinas-Casado J, et al. The 3-day bladder diary is a feasible, reliable and valid tool to evaluate the lower urinary tract symptoms in women. Neurourology and urodynamics. 2015;34(2):128-32.
15. Sing Kai Lo JN, Yuelong Cao,. ADDITIVE EFFECT OF INTERFERENTIAL THERAPY OVER PELVIC FLOOR EXERCISE ALONE IN THE TREATMENT OF FEMALE URINARY STRESS AND URGE INCONTINENCE: A RANDOMIZED CONTROLLED TRIAL. Hong kong physiotherapy journal. 2003;21(1):6.
16. Strączyńska A, Weber-Rajek M, Strojek K, Piekorz Z, Styczyńska H, Goch A, et al. The Impact Of Pelvic Floor Muscle Training On Urinary Incontinence In Men After Radical Prostatectomy (RP) - A Systematic Review. Clinical interventions in aging. 2019;14:1997-2005.
17. Miller JM, Hawthorne KM, Park L, Tolbert M, Bies K, Garcia C, et al. Self-Perceived Improvement in Bladder Health After Viewing a Novel Tutorial on Knack Use: A Randomized Controlled Trial Pilot Study. J Womens Health (Larchmt). 2020;29(10):1319-27.
18. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods. 2007;39(2):175-91.
19. Centemero A, Rigatti L, Giraudo D, Lazzeri M, Lughezzani G, Zugna D, et al. Preoperative pelvic floor muscle exercise for early continence after radical prostatectomy: a randomised controlled study. European urology. 2010;57(6):1039-43.
20. Filocamo MT, Li Marzi V, Del Popolo G, Cecconi F, Marzocco M, Tosto A, et al. Effectiveness of early pelvic floor rehabilitation treatment for post-prostatectomy incontinence. European urology. 2005;48(5):734-8.
21. Yakıt Yeşilyurt S, Özengin N, Topçuoğlu MA. Comparing the efficacy of the Knack maneuver on pelvic floor muscle function and urinary symptoms using different teaching methods: a prospective, nonrandomized study. International urogynecology journal. 2022;33(10):2895-903.
22. Hinata N, Murakami G. The urethral rhabdosphincter, levator ani muscle, and perineal membrane: a review. BioMed research international. 2014;2014:906921.
23. Yu K, Bu F, Jian T, Liu Z, Hu R, Chen S, et al. Urinary incontinence rehabilitation of after radical prostatectomy: a systematic review and network meta-analysis. Frontiers in oncology. 2023;13:1307434.
| Issue | Articles in Press | |
| Section | Research Article(s) | |
| Keywords | ||
| Pelvic floor muscle training, Electrical stimulation; Urinary incontinence; Prostatectomy; Quality of life | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Sheibanifar M, Ebrahimabadi Z, Niknam H, Okhovatian F, Akbarzadeh Baghban A, Mortezanejad M. Integrative Physical Therapy Versus Pelvic Floor Muscle Training for Post-Prostatectomy Stress Urinary Incontinence: A Randomized Controlled Trial. jmr. 2025;(-).
