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Sandy Srinivas, MD

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Can Combining Transrectal Ultrasound and Pelvic Floor Muscle Exercise Improve Postoperative Urinary Incontinence?

By: Chris Schimpf, BS
Posted: Wednesday, July 19, 2023

Research published in the European Journal of Medical Research suggests that combining transrectal ultrasound with simultaneous urologist-guided pelvic floor muscle exercise may improve urinary continence in patients following radical prostatectomy. According to Tiejun Yang, MD, PhD, of the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, China, the technique acted as an independent prognostic factor and played a significant role in improving immediate, early, and long-term urinary continence after radical prostatectomy.

“Pelvic floor muscle exercise is the most common conservative intervention for postoperative urinary incontinence,” the researchers noted. “Although it is generally believed that pelvic floor muscle contractions can be achieved after verbal or written instructions, up to 50% of patients fail to achieve effective contractions after basic instructions. Therefore, there is an urgent need to improve the effectiveness of pelvic floor muscle exercise and to standardize guidance.”

A total of 114 patients who underwent radical prostatectomy between November 2018 and April 2021 were included in the retrospective study. The observation group consisted of 50 patients who underwent transrectal ultrasound while receiving simultaneous pelvic floor muscle exercise instruction from a urologist, whereas the 64 patients in the control group received verbal instructions alone. Follow-up occurred at 2 weeks and 1, 3, 6, and 12 months after surgery, during which an oral questionnaire was used to evaluate urinary continence.

In the observation group, the urinary continence rate at 2 weeks and 1, 3, 6, and 12 months after radical prostatectomy was 52%, 70%, 82%, 88%, and 98%, respectively, versus 29.7%, 39.1%, 57.8%, 70.3%, and 84.4% in the control group (P < .05). In addition, the investigators observed that transurethral resection of the prostate may be a negative factor for postoperative urinary continence and suggested that further multicenter, large-scale, and prospective research is necessary.

Disclosure: The study authors reported no conflicts of interest.


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