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Levy A, Fleishman A, Jackson M, et al. Using Preoperative Pelvic Floor Assessment to Predict Early Return of Continence after Robotic Radical Prostatectomy. Urology. 2021;155:160-164doi: 10.1016/j.urology.2021.04.029.
Levy, A., Fleishman, A., Jackson, M., Waisman, A., Chan, M., Kleeman, A., Crociani, C., McAnally, K., Leader, J., Warnhoff, M., Jiang, D., Wagner, A., & Chang, P. (2021). Using Preoperative Pelvic Floor Assessment to Predict Early Return of Continence after Robotic Radical Prostatectomy. Urology, 155160-164. https://doi.org/10.1016/j.urology.2021.04.029
Levy, Alison, et al. "Using Preoperative Pelvic Floor Assessment to Predict Early Return of Continence after Robotic Radical Prostatectomy." Urology vol. 155 (2021): 160-164. doi: https://doi.org/10.1016/j.urology.2021.04.029
Levy A, Fleishman A, Jackson M, Waisman A, Chan M, Kleeman A, Crociani C, McAnally K, Leader J, Warnhoff M, Jiang D, Wagner A, Chang P. Using Preoperative Pelvic Floor Assessment to Predict Early Return of Continence after Robotic Radical Prostatectomy. Urology. 2021 Sep;155:160-164. doi: 10.1016/j.urology.2021.04.029. Epub 2021 May 07. PMID: 33971191.
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Urology. 2021 Sep;155:160-164. doi: 10.1016/j.urology.2021.04.029. Epub 2021 May 07.

Using Preoperative Pelvic Floor Assessment to Predict Early Return of Continence after Robotic Radical Prostatectomy.

Urology

Alison Levy, Aaron Fleishman, Max Jackson, Adrian Waisman, Marianne Chan, Allison Kleeman, Catrina Crociani, Kyle McAnally, Jenna Leader, Marysa Warnhoff, David Jiang, Andrew Wagner, Peter Chang

Affiliations

  1. Lahey Hospital and Medical Center, Burlington, MA.
  2. Beth Israel Deaconess Medical Center, Boston, MA.
  3. Beth Israel Deaconess Medical Center, Boston, MA. Electronic address: [email protected].

PMID: 33971191 DOI: 10.1016/j.urology.2021.04.029

Abstract

OBJECTIVE: To evaluate whether pre-operative pelvic floor physical therapy (PFPT) parameters may predict early return of urinary continence after RP. While long-term urinary continence is eventually achieved in most patients who undergo radical prostatectomy (RP), predicting when patients will become continent is challenging. Prior studies aiming to predict return of post-operative continence have not evaluated patient-specific pelvic floor strength parameters.

METHODS: We reviewed a prospectively maintained database of patients undergoing RP who underwent pre-operative PFPT consultation and completed 3-month patient-reported quality of life evaluation. Trained therapists documented pelvic strength parameters. Urinary continence was defined as using 0 or 1 pad per day. We evaluated the association of PFPT parameters with urinary continence at 3 months, adjusting for other factors that could affect continence.

RESULTS: 144 men met inclusion criteria. The majority of patients underwent nerve-sparing procedures and had intermediate- or high-risk prostate cancer. At 3 months, 90 of 144 (62.5%) were continent, while 54 of 144 (37.5%) were not. On multivariable analysis, prostate volume (OR 0.98, 95% CI 0.96-1.00) and pelvic floor endurance (OR 2.71, 95% CI 1.23-6.17) were significantly associated with being continent at 3 months. 56 of 76 (74%) men with good pelvic floor endurance were continent at 3 months, while only 34 of 68 (50%) men with poor endurance were continent (P = .006).

CONCLUSION: Pre-operative assessment of pelvic floor endurance is an objective measure that may allow more accurate prediction of early continence after radical prostatectomy. Improved patient counseling could positively impact patient satisfaction and quality of life and reduce decision regret.

Copyright © 2021 Elsevier Inc. All rights reserved.

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