Case series: pelvic floor rehabilitation for urinary incontinence post prostatectomy

Background: Healthcare professionals involved in the care of men diagnosed with prostate cancer know the importance of providing a holistic plan of care for post prostatectomy patients. There are several case studies that have found it beneficial for adding pelvic floor muscle rehabilitation to post surgery protocols along with other treatments including biofeedback and electrotherapeutic modalities. Few other studies differ their opinion that rehabilitation should begin pre-surgery and continue post-surgery with no therapeutic modalities. Currently, there are limited studies in recommendation for pre and post screening and in addition of the treatment approaches used by healthcare professionals to ensure to improve the quality of life and return of function to the pelvic floor in men who have undergone prostatectomy. Objective: To measure the effectiveness of pelvic floor muscle rehabilitation in male patients with urinary incontinence post prostatectomy. Design: A review of literature of before-after studies, reviews, prospective and qualitative studies and case series on the effect of pelvic floor muscle rehabilitation for urinary incontinence after prostatectomy. Results: A total of 5 patients were identified for the study. The validity of the trials was moderate to high for a reduction in incontinence from 6 months to 1 year from date of surgery. There was a trend in the reviews for pre-operative and post-operative management using pelvic floor muscle rehabilitation to improve incontinence. The qualitative study showed evidence of the use of behavioral therapy to overcome intrinsic and extrinsic barriers during pelvic floor muscle rehabilitation for improving the outcomes of male urinary incontinence after prostatectomy surgery. Conclusion: More research is needed for the cases to further show the significance of holistic care utilizing physiotherapy interventions. There is some evidence that both post-operative and early pre- operative pelvic floor rehabilitation is beneficial for better outcomes of the level of male incontinence after prostatectomy. Limitations: A literature review on the efficacy of physiotherapy on the treatment of post prostatectomy urinary incontinence reveals that physiotherapists have an integrated role as a part of the healthcare team for improving the quality of life of men after prostatectomy. Further research is necessary to validate the efficacy of physiotherapy interventions.