Early postoperative pelvic-floor biofeedback improves erectile function in men undergoing radical prostatectomy: a prospective, randomized, controlled trial

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39
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article
Data de publicação
2012
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NATURE PUBLISHING GROUP
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INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH, v.24, n.5, p.174-178, 2012
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Erectile dysfunction (ED) and urinary incontinence are common complications following radical prostatectomy (RP). Although pelvic-floor biofeedback training (PFBT) may improve urinary continence following RP, its effects on the recovery of potency are unknown. Fifty-two patients selected for RP were prospectively randomized for a treatment group (n=26) receiving PFBT once a week for 3 months and home exercises or a control group (n=26), in which patients received verbal instructions to contract the pelvic floor. Erectile function (EF) was evaluated with the International Index of Erectile Function-5 (IIEF-5) before surgery and 1, 3, 6 and 12 months postoperatively. Patients were considered potent when they had a total IIEF-5 score >20. Continence status was assessed and defined as the use of no pads. Groups were comparable in terms of age, body mass index, diabetes, pathological tumor stage and neurovascular bundle preservation. A significant reduction in IIEF-5 scores was observed after surgery in both groups. In the treatment group, 8 (47.1%) patients recovered potency 12 months postoperatively, as opposed to 2 (12.5%) in the control group (P=0.032). The absolute risk reduction was 34.6% (95% confidence interval (CI): 3.8-64%) and the number needed to treat was 3 (95% CI: 1.5-17.2). A strong association between recovery of potency and urinary continence was observed, with continent patients having a 5.4 higher chance of being potent (P=0.04). Early PFBT appears to have a significant impact on the recovery of EF after RP. Urinary continence status was a good indicator of EF recovery, with continent patients having a higher chance of being potent.
Palavras-chave
biofeedback, erectile dysfunction, prostatectomy, urinary incontinence
Referências
  1. Burkhard FC, 2006, J UROLOGY, V176, P189, DOI 10.1016/S0022-5347(06)00574-X
  2. Burnett AL, 2006, J UROLOGY, V176, P882, DOI 10.1016/j.juro.2006.04.020
  3. Burnett AL, 2007, J UROLOGY, V178, P597, DOI 10.1016/j.juro.2007.03.140
  4. CLAES H, 1993, BRIT J UROL, V71, P52, DOI 10.1111/j.1464-410X.1993.tb15880.x
  5. Dorey G, 2004, BRIT J GEN PRACT, V54, P819
  6. Dorey Grace, 2003, J Wound Ostomy Continence Nurs, V30, P44, DOI 10.1067/mjw.2003.7
  7. Dorey Grace, 2007, Br J Nurs, V16, P1194
  8. Dubbelman YD, 2006, EUR UROL, V50, P711, DOI 10.1016/j.eururo.2006.06.009
  9. Fandel TM, 2008, J SEX MED, V5, P1866, DOI 10.1111/j.1743-6109.2008.00881.x
  10. Filocamo MT, 2005, EUR UROL, V48, P734, DOI 10.1016/j.eururo.2005.06.004
  11. Hinh P, 2008, ADV UROL
  12. Hsieh PS, 2003, BJU INT, V92, P470, DOI 10.1046/j.1464-410X.2003.04373.x
  13. Kao TC, 2000, J UROLOGY, V163, P858, DOI 10.1016/S0022-5347(05)67819-6
  14. Kaufmann O, 2008, BJU INT, V102, P1026, DOI 10.1111/j.1464-410X.2008.07760.x
  15. Kendirci M, 2006, CURR OPIN UROL, V16, P186, DOI 10.1097/01.mou.0000193407.05285.d8
  16. Kundu SD, 2004, J UROLOGY, V172, P2227, DOI 10.1097/01.ju.0000145222.94455.73
  17. LAVOISIER P, 1988, J UROLOGY, V139, P176
  18. LAVOISIER P, 1986, J UROLOGY, V136, P936
  19. Loppenberg B, 2010, J UROLOGY, V184, P944, DOI 10.1016/j.juro.2010.05.032
  20. Loughlin KR, 2010, J UROLOGY, V183, P871, DOI 10.1016/j.juro.2009.11.011
  21. Marien T, 2009, J UROLOGY, V181, P1817, DOI 10.1016/j.juro.2008.11.105
  22. Marien TP, 2008, BJU INT, V102, P1581, DOI 10.1111/j.1464-410X.2008.07921.x
  23. Matthews VB, 2009, DIABETOLOGIA, V52, P1409, DOI 10.1007/s00125-009-1364-1
  24. McCullough Andrew R, 2005, Rev Urol, V7 Suppl 2, pS3
  25. McCullough AR, 2010, J UROLOGY, V183, P2451, DOI 10.1016/j.juro.2010.01.062
  26. McCullough AR, 2008, J SEX MED, V5, P476, DOI 10.1111/j.1743-6109.2007.00700.x
  27. Michl UHG, 2006, J UROLOGY, V176, P227, DOI 10.1016/S0022-5347(06)00632-X
  28. Miles CL, 2007, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD005540.pub2
  29. Montorsi F, 2008, EUR UROL, V54, P924, DOI 10.1016/j.eururo.2008.06.083
  30. Montorsi F, 1997, J UROLOGY, V158, P1408, DOI 10.1016/S0022-5347(01)64227-7
  31. Mulhall JP, 2009, J UROLOGY, V181, P462, DOI 10.1016/j.juro.2008.10.047
  32. Mulhall JP, 2007, J SEX MED, V4, P538, DOI 10.1111/j.1743-6109.2007.00486.x
  33. Nehra A, 2005, J UROLOGY, V173, P2067, DOI 10.1097/01.ju.0000158456.41788.93
  34. Noldus J, 2002, EUR UROL, V42, P118, DOI 10.1016/S0302-2838(02)00219-1
  35. Padma-Nathan H, 2008, INT J IMPOT RES, V20, P479, DOI 10.1038/ijir.2008.33
  36. Penson DF, 2005, J UROLOGY, V173, P1701, DOI 10.1097/01.ju.0000154637.38262.3a
  37. Raina R, 2006, INT J IMPOT RES, V18, P77, DOI 10.1038/sj.ijir.3901380
  38. Raina R, 2007, BJU INT, V100, P1317, DOI 10.1111/j.1464-410X.2007.07124.x
  39. Ribeiro LHS, 2010, J UROLOGY, V184, P1034, DOI 10.1016/j.juro.2010.05.040
  40. Rosen RC, 1999, INT J IMPOT RES, V11, P319
  41. Salomon G, 2009, J SEX MED, V6, P498, DOI 10.1111/j.1743-6109.2008.01089.x
  42. Saranchuk JW, 2005, J CLIN ONCOL, V23, P4146, DOI 10.1200/JCO.2005.12.922
  43. Stanford JL, 2000, JAMA-J AM MED ASSOC, V283, P354, DOI 10.1001/jama.283.3.354
  44. Treiyer A, 2011, J UROLOGY, V185, P1681, DOI 10.1016/j.juro.2010.12.052
  45. Van Kampen M, 2003, PHYS THER, V83, P536
  46. von Bodman C, 2011, J SEX MED, V8, P567, DOI 10.1111/j.1743-6109.2010.01911.x
  47. WALSH PC, 1987, J UROLOGY, V138, P823
  48. WESPES E, 1990, EUR UROL, V18, P45
  49. Yossepowitch O, 2007, J UROLOGY, V178, P493, DOI 10.1016/j.juro.2007.03.105