Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada.
Cancer Rehabilitation and Survivorship, University Health Network, Toronto, Canada.
PM R. 2020 Jan;12(1):55-63. doi: 10.1002/pmrj.12157. Epub 2019 Jul 3.
Urinary incontinence (UI) is an important side effect of radical prostatectomy (RP). Coactivation of surrounding muscles via novel techniques for pelvic floor rehabilitation known as Pfilates and Hypopressives has not been compared to pelvic floor muscle exercises (PFMXs) for UI.
To assess the feasibility and efficacy of isolated PFMXs with and without the addition of Pfilates and Hypopressives on UI recovery following RP.
Randomized controlled trial.
Participants were recruited from a community and tertiary cancer center in Toronto, Canada.
A total of 226 patients undergoing RP were assessed for eligibility. One hundred twenty-two patients were eligible and 50 consented to participate; 37 participants completed the trial.
Participants were randomized to either isolated PFMX (control) or PFMX plus Pfilates and Hypopressives (advanced pelvic floor exercises; APFX) groups. PFMX participants (n = 25) received instructions for isolated pelvic floor contractions starting with 30 contractions per day during weeks 1 to 2 up to 180 per day for weeks 7 to 26. The APFX group (n = 25) received a comparable volume of exercises.
Feasibility was assessed by rates of recruitment, adverse events, and study-arm compliance. Information about UI and quality of life was collected 1 week before surgery and at 2, 6, 12, and 26 weeks after surgery.
The recruitment rate was 41%, adherence to the PFMXs and APFXs was >70%, and there were no reported adverse events. Between-group differences were observed in the frequency of self-reported 24-hour urinary leakage (rate ratio 0.45, 95% confidence interval [CI] 0.2-0.98) and during waking hours (rate ratio 0.43, 95% CI 0.20-0.91) at 26 weeks after surgery favoring APFX.
Pfilates and Hypopressives are feasible in men undergoing RP, and preliminary data suggest a potential benefit in aiding recovery of urinary control. Larger studies with longer follow-up are warranted.
II.
尿失禁（UI）是根治性前列腺切除术（RP）的一个重要副作用。通过称为 Pfilates 和 Hypopressives 的新型盆底康复技术来共同激活周围肌肉，尚未与盆底肌肉锻炼（PFMX）进行比较，以了解其对 UI 的作用。
评估单独进行 PFMX 以及在此基础上增加 Pfilates 和 Hypopressives 对 RP 后 UI 恢复的可行性和疗效。
随机对照试验。
参与者从加拿大多伦多的社区和三级癌症中心招募。
共评估了 226 例接受 RP 的患者，其中 122 例符合条件，50 例同意参加，37 例完成了试验。
将参与者随机分为单独进行 PFMX（对照组）或 PFMX 加 Pfilates 和 Hypopressives（高级盆底运动；APFX）组。PFMX 组（n=25）接受单独进行盆底收缩的指导，从第 1 周到第 2 周每天进行 30 次收缩，第 7 周到第 26 周每天进行 180 次收缩。APFX 组（n=25）接受了相当数量的运动。
通过招募率、不良事件和研究组依从性评估可行性。在手术前 1 周以及手术后 2、6、12 和 26 周收集有关 UI 和生活质量的信息。
招募率为 41%，PFMX 和 APFX 的依从性均>70%，且未报告不良事件。在术后 26 周时，两组之间自我报告的 24 小时尿漏频率（比值比 0.45，95%置信区间 [CI] 0.2-0.98）和清醒时的尿漏频率（比值比 0.43，95%CI 0.20-0.91）存在差异，APFX 组的频率较低。
Pfilates 和 Hypopressives 适用于接受 RP 的男性，初步数据表明其在辅助恢复控尿方面具有潜在益处。需要进行更大规模、随访时间更长的研究。
II。
