Kegel exercises are not the only way to help residents recover urinary continence after prostate surgery, according to a new study.
In fact, most men may benefit from therapy aimed at normalizing pelvic floor function, as opposed to a pure strengthening program, said researcher Kelly M. Scott, M.D., of UT Southwestern Medical Center, Dallas.
In a study of 136 post-surgery patients, researchers were surprised to find that only 18% had weak or underactive muscles. Others had overactive or tight muscles. And almost all had evidence of both, reported Scott.
“[T]he study’s findings are counter to the prevailing idea, which is that these men must have very weak muscles,” Scott said.
The traditional standard of care – Kegel-based strengthening – can be counterproductive for post-prostatectomy patients whose muscles are tight or spasming, added study co-author Michelle Bradley, PT. When researchers instead tailored therapy to individual diagnoses, incontinence improved for 87% of the study participants, they reported. And more than half achieved optimal outcomes: needing two or fewer protective pads per day.
The personalized therapy approach also reduced post-operative pain, investigators found. The number of participants reporting pain dropped from 27% to 14% by the end of the four-week therapy.
“An individualized pelvic PT program … can be helpful in reducing [stress urinary incontinence] and pelvic pain,” Scott concluded.
The study was published online in the journal International Urology and Nephrology.
