REHABILITATION OF URINARY CONTINENCE IN PATIENTS AFTER LAPAROSCOPIC RADICAL PROSTATECTOMY

Introduction. Urinary incontinence is one of the common complications of laparoscopic radical prostatectomy performed in patients with prostate cancer. Conservative measures for postprostatectomy urinary incontinence (PPUI) after radical prostatectomy include lifestyle changes and pelvic floor muscle training. Providing the patient with information about the functioning of the pelvic muscles during exercise (biofeedback) helps to control the activity and strength of the muscles and increases the efficiency of exercises. Materials and methods. A total of 44 patients who underwent laparoscopic radical prostatectomy performed pelvic floor muscle training plus biofeedback. A questionnaire on the ICIQ-SF scale to objectify complaints was used. Education, pelvic floor muscle training and control of the efficiency of exercises were provided using biofeedback with electromyogram. Results. The skill of isolated contraction of perineal muscles with minimal participation of the anterior abdominal wall muscles was acquired in 37 (84.1%) patients during 2-4 sessions. The rest 7 men (15.9%) required regular support using biofeedback with two channel electromyography. This group of patients performed training once a week. The duration of urinary incontinence in patients who learnt the isolated contraction was 3.7 (1.1-39) months compared to 7 (1.5-11) months in men who required additional biofeedback (p=0.13). Conclusions. Pelvic floor muscle training is an effective way to improve urinary continence after radical prostatectomy, including laparoscopic one. The use of biofeedback using electromyogram, especially with two channels, allows the patient to receive visually accessible information about the functioning of the pelvic muscles and their antagonists (abdominal muscles). This method improves the efficiency of teaching patients with urinary incontinence and pelvic floor muscle training.

complications of radical prostatectomy, urinary incontinence, pelvic floor muscle training, biofeedback