An objective measurement of urinary continence recovery with pelvic floor physiotherapy following robotic assisted radical prostatectomy

Background: To assess the impact of structured pelvic floor physiotherapy including repeated standardized measurements in regaining urinary continence in those men who have undergone a robotic-assisted laparoscopic radical prostatectomy (RALP). Methods: A retrospective database was created on men who had undergone a RALP while under the care of two senior urological surgeons between January 2013 and July 2016 and then took part in a formal pelvic floor rehabilitation program were included in the study. Men were initially seen pre-operatively and then after removal of their indwelling catheter commenced their structured continence program. They were instructed to record their pad weights commencing at week four post-RALP. For each subsequent week, an average of the 24-hour urine leakage was recorded and compared to their first recorded week (baseline) to assess improvement of urinary continence over time. Results: Forty-five men with a median age of 63.7 years were followed up for a mean of 11.3 weeks postoperatively. The mean daily urine leakage during the first recorded week was 408.0 mL. This decreased to 205.8 and 110.1 mL at 2 and 3 months post-RALP (P < 0.05). This equated to a significant 57.1% (95% CI, 52.9% to 61.3%) and 75.6% (95% CI, 72.3% to 78.8%) improvement in urinary leakage at the same respective time points. Conclusions: There is considerable improvement of urinary leakage following RALP in the short-term in men who participated in a structured, physiotherapist-led pelvic floor re-training program.