Pre-operative functional pelvic floor muscle training in radical prostatectomy: identifying feasibility

Physiotherapy-guided pelvic floor muscle training (PFMT) prior to Radical Prostatectomy (RP) may result inreduced severity and duration of post-operative Urinary Incontinence (UI). Lack of homogeneity in methodology and low numbers of studies are barriers in current research. Pre-operative standard PFMTcompared with functional based PFMTrequires exploration. The objectives of this study are to assess protocol feasibility and the effect size between groups with respect to post-operative UI.
Methods: 30 men undergoing RP at a single site will be randomised to the six exercise functional based program or tostandard care pre-operatively. Post-operative UI will be measured via a 3 day pad weight diary and the ICIQ-UISF at 4, 12and 26 weeks. Feasibility will be determined by the ability to recruit 30 participants within 12 months, outcome measure completion and program adherence.
Results: 27 participants from a total of 49 men who have undergone RP have beenrecruited within 16 months. 11 men havecompleted the study. Themes arising around feasibility include the timing of the provision of information, recruitment criteria with regards to limited validation ofmultilinguistic outcome measures, ongoing development and training in physiotherapy pelvic floor assessment techniques and limited single site surgical numbers.
Conclusions: Considerations include: Inclusion of Non-English Speaking Back-ground participants and multilinguistic outcome measure validation; Multi-siterecruitment to enhance surgery numbers; Alternative assessment techniques such as transperineal real time ultrasound andconsideration of ongoing training opportunities for physiotherapists; and earlier provision of information during recruitment phase.