EVALUATION OF THERAPY EFFECT ON URINARY INCONTINENCE IN MEN AFTER RADICAL ROBOTIC-ASSISTED PROSTATECTOMY WITHIN THE PPA REHASPRING CONCEPT

Abstract

Background: Malignant prostate cancer is one of the most common oncological diseases in men. If the tumor is localized only on the prostate, the method of treatment is radiotherapy or radical prostatectomy. After radical prostatectomy, 80% of men experience erectile dysfunction and 10-15% experience various degrees of permanent stress incontinence. Physiotherapy of the pelvic floor muscles is the most commonly recommended conservative treatment for urinary incontinence, which a high percentage of men have after surgery.
Sample: The research sample consisted of 23 men who attended an outpatient physiotherapy facility. Group A (n=9, age 57.4 ± 6.9 years) consisted of probands who underwent the first initial examination before the planned radical prostatectomy and were continent. Group B (n=14, age 66.3 ± 10 years) included patients who first underwent RARP surgery and subsequently came for an initial examination to a physiotherapist at an interval of 3-9 weeks after the procedure. Group B probands suffered from varying amounts of urinary leakage after surgery.
Methods: The Rehaspring questionnaires of the PPA (Palascak Pelvic Approach) concept and the ICIQ-SF Guidelines questionnaire for the quantification of urinary leakage were used to obtain the results of therapy effectiveness and all necessary data for the study.
Results: The most significant decrease was between the initial examination of group A (9.8±6.8) ICIQ-SF points and group B (18.5±4.97) ICIQ-SF and between the 1st and 2nd control examinations of group A ( 6.3±4.9) ICIQ-SF points and group B (9.64±5.7) ICIQ-SF points. Urinary incontinence decreased by 36.2% in the group that used rectal weights in therapy.
Conclusions: The results of the study showed that regular exercise and strengthening of the pelvic floor muscles as well as the use of rectal weights have an effect on the reduction of urinary incontinence. A study demonstrated that preoperative patient instruction reduces urinary incontinence after RARP.