Individualized PT Can Reduce Incontinence After Prostatectomy

For men with postprostatectomy stress urinary incontinence (SUI), an individualized pelvic physical therapy (PT) program aimed at normalizing pelvic floor dysfunction (PFD) is associated with a decrease in SUI and pelvic pain, according to a study published online December in International Urology and Nephrology.

Kelly M. Scott, M.D., from the UT Southwestern Medical Center in Dallas, and colleagues conducted a retrospective chart review of 136 patients with postprostatectomy SUI treated with pelvic PT. Patients were classified as having underactive, overactive, or mixed-type PFD and were treated accordingly with a tailored program.

Overall, 25 patients had underactive PFD and were treated with strengthening; 13 had overactive PFD and were treated with relaxation training; and 98 patients had mixed-type PFD and were treated with a combination of relaxation and strengthening. The researchers observed significant decreases in pad usage per day and pelvic pain and increased pelvic floor strength among the patients, even in those who mainly received pelvic floor relaxation training to normalize pelvic floor overactivity.

"Prospective and randomized trials would be helpful to ascertain whether individualized pelvic PT treatment is preferable to standard Kegel prescription in this population," the authors write. "This study suggests that a more individualized approach, geared toward normalizing pelvic floor function, is a potentially valid way to manage postprostatectomy urinary incontinence and pelvic pain."

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