Department of Physical Therapy Student Theses, Dissertations and Capstones

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD) in Physical Therapy

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

Department

College of Health Care Sciences - Physical Therapy Department

First Advisor

Shari Rone-Adams

Second Advisor

M.Samual Cheng

Third Advisor

Debra Stern

Publication Date / Copyright Date

2020

Publisher

Nova Southeastern University

Abstract

Background: Despite advancements in surgical techniques through the use of robotic assisted radical prostatectomy, urinary incontinence remains the most common side effect following surgery affecting men’s quality of life.

Objective: To explore the role of a single pre-operative pelvic floor muscle training session. To determine if men who receive the training session have a decrease incidence of incontinence post-op, whether pelvic floor muscle strength pre-operatively is an independent predictor of urinary incontinence, and the impact of incontinence on quality of life in men following a robotic-assisted radical prostatectomy in the early stages post-operatively.

Design: A two part study with a retrospective portion and a prospective pilot cohort study.

Method: Electronic medical record review of 140 men who have undergone robotic assisted radical prostatectomy was conducted for the retrospective study. For the prospective study, twenty consecutive patients who underwent robotic assistedradical prostatectomy were randomized into 2 groups, the intervention group received the pelvic floor muscle training and the control group did not. Outcome measures included pelvic floor muscle strength, 24 hour pad test, and quality of life instruments.

Results: Urinary incontinence was significantly less at 6 weeks post-op with one session of pre-op pelvic floor muscletraining. None of the demographics and PF muscle performance pre-op, with the exception of race, related to incontinencepost-op. The pelvic floor muscle training session alone was related to improved continence post-op. Pelvic floor musclestrength (p = .038) and endurance (p <.001) improved over time and more rapidly in the pelvic floor muscle training group with coinciding diminished severity of incontinence. Functional impact of incontinence decreases over time in both groups with asignificantly lesser impact in the PFMT group (IIQ-7, p = .008, UCLA, p <.001). The impact in the PFMT group at 6 weeks was less than at 3 months in the control group.

Conclusions: The results of this study indicate that a single, pre-operative pelvic floor muscle training session may improve early continence and quality of life outcomes after robotic assisted radical prostatectomy. Larger scale studiesshould be conducted to corroborate the findings.

Disciplines

Physical Therapy

Keywords

Pelvic floor muscle training, Prostatectomy, Urinary incontinence

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