Pfilates and Hypopressives for the Treatment of Urinary Incontinence after Radical Prostatectomy: Results of a Feasibility Randomized Controlled Trial.

BACKGROUND: Urinary incontinence (UI) is an important side effect of radical prostatectomy (RP). Co-activation of surrounding muscles via novel techniques for pelvic floor rehabilitation known as Pfilates and Hypopressives have not been compared to pelvic floor muscle exercises (PFMX) for UI.

OBJECTIVE: To assess the feasibility and efficacy of isolated PFMX with and without the addition of Pfilates and Hypopressives on UI recovery following RP.

DESIGN: Randomized controlled trial SETTING: Participants were recruited from a community and tertiary cancer centre in Toronto, Canada PARTICIPANTS: A total of 226 patients undergoing RP were assessed for eligibility. One hundred twenty-two patients were eligible and 50 consented to participate.

METHODS: Participants were randomized to either isolated PFMX (control) or PFMX plus Pfilates and Hypopressives (advanced pelvic floor exercises; APFX). PFMX participants received instructions for isolated pelvic floor contractions starting with 30 contractions per day during weeks 1-2 up to 180/day for weeks 7-26. The APFX group received comparable volume of exercises.

OUTCOME MEASUREMENTS: Feasibility was assessed by rates of recruitment, adverse events, and study-arm compliance. UI and quality of life were collected 1 week prior to surgery and at 2, 6, 12, and 26 weeks after surgery.

RESULTS: Recruitment rate was 41%, adherence to the PFMX and APFX was greater than 70%, and no reported adverse events. Between-group differences were observed in frequency of self-reported 24-hour urinary leakage (rate ratio: 0.45, 95%CI: 0.22, 0.98) and during waking hours (rate ratio: 0.43, 95%CI: 0.20, 0.91) at 26-weeks post-surgery favouring APFX. This study was limited by the small sample size and short follow-up.

CONCLUSIONS: Pfilates and Hypopressives are feasible in men undergoing RP and preliminary data suggest potential benefit in aiding recovery of UI. Larger studies with longer follow-up are warranted. This article is protected by copyright. All rights reserved.