Efficacy of a supervised low-intensity regimen of perioperative pelvic floor muscle training in reducing postprostatectomy urinary incontinence: A randomized controlled trial

Introduction & Objectives To evaluate the efficacy of preoperative biofeedback combined with an assisted low-intensity regimen of postoperative pelvic floor muscle training (PFMT) in reducing the incidence, duration and severity of urinary incontinence in patients undergoing open radical prostatectomy (RP). Material & Methods Design: Single-center, randomized control trial. The intervention group received the day before RP a training session with biofeedback, supervised oral and written instructions on Kegel exercises and a structured program of postoperative PFMT; patients underwent control visits, including a session of biofeedback, at monthly intervals only. As standard of care, the control group received, after catheter removal, only oral and written instructions on Kegel exercises to be performed at home and underwent control visits at 1, 3 and 6 months follow-up. At each visit the number of incontinence episodes and of diapers per week and patient-reported outcome measures (ICIQ-UI, OAB-ICIQ, UCLA-PCI, IPSS-QoL) were assessed in both groups. All participants were followed-up for a period of at least six months after catheter removal. The primary outcome was the recovery of continence strictly defined as a ICIQ-UI score of zero. The differences between groups were analyzed using Fisher test and non-parametric statistics and significance threshold was set at p