Effectiveness of Physiotherapy to Treat the Urinary Incontinence and Erectile Dysfunction Post Retropubic Prostatectomy
Condition: Urinary Incontinence; Erectile Dysfunction
MeSH terms: Urinary Incontinence; Enuresis; Erectile Dysfunction
Study type: Interventional

Summary: 
      The prostate cancer is the most common parenchymal neoplasia in men over 45 years old.
      Radical prostatectomy is curative treatment is most used today. Urinary incontinence and
      erectile dysfunction are the main complications of radical prostatectomy. Physical therapy
      has been used as a form of conservative treatment of these complications. However, the role
      of physiotherapy in the treatment of these complications is not well defined in the
      literature. We will do a randomized controlled study with patients undergoing radical
      prostatectomy. After removal of the Foley catheter, patients will be randomized into 3
      groups: control group, group of pelvic floor exercises and anal electrostimulation group.
      These patients will be evaluated preoperatively in an attempt to meet prognostic factors for
      urinary incontinence and erectile dysfunction. They will be followed by 2 years after
      surgery, to assess whether the therapy will alter the course of urinary continence and
      erectile function in these patients.
    

Detailed description: 
      Randomization was performed by a team of external statistics to the research team, using the
      method of randomization in blocks of three, who were randomly selected. The group to which
      the patient was allocated to researchers only be informed at the time of randomization, if
      patients satisfied the criteria for inclusion and exclusion.

      Will be evaluated preoperatively: urodynamic studies and clinical evaluation. The following
      clinical data were evaluated: Body Mass Index (BMI), comorbidities, disease staging and
      sociodemographic information.

      The following parameters will be evaluated in the pre-operative and after one, three, six and
      twelve months after surgery: evaluating the strength of the pelvic floor through
      perineometry, the 1 hour pad test, electromyographic evaluation of pelvic floor, and the
      application of instruments validated for the Portuguese language. The follow instruments will
      be applied: International Index of Erectile Function - 5 questions (IIEF-5), International
      Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), International Prostate
      Symptom Score (IPSS).
    

Intervention name(s): group of pelvic floor exercises; anal electrostimulation group
Intervention type(s): Procedure; Procedure
Intervention description(s): contraction of the pelvic floor muscles sustained for 5 seconds, hip adductors using pillow and elevation of the hip, 30 repetitions of each exercise; The anal electrical stimulation protocol was performed by a physical therapist for seven weeks, twice per week, using the apparatus Dualpex 961 Uro® Quark, with frequency of 35 Hz, and the intensity determined according to the tolerance of the patient, lasting 20 minutes.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: urinary incontinence; erectile dysfunction; Retropubic Prostatectomy; Physiotherapy