| YOU CAN BEAT POST-PROSTATECTOMY INCONTINENCE
A new Italian study has demonstrated that twelve simple 35 mins treatment sessions, using equipment that is readily available for use at home, resulted in almost all men regaining continence at 6 months. (Mariotti, 2009).
The PFXA, Peritone, Pericalm and Anuform electrode allow you to mimic this treatment in privacy at home. Read on...... |
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Pelvic floor exercises are strongly recommended for men both before and following a prostatectomy, a recommendation confirmed by worldwide experts at the International Consultation on Incontinence in July 2008.
Research has shown that strengthening the pelvic floor muscles can improve sexual function and overcome urinary incontinence after radical prostatectomy.
One study found that self-directed exercise, using verbal and written instructions, can work just as well as intensive physiotherapy (Moore and others, 2008). But over one third of men in this study still suffered from incontinence one year after prostate cancer surgery regardless of whether they exercised at home or saw a physio regularly.
BUT a new Italian study has now demonstrated that 12 treatment sessions each of 35 mins duration, starting very soon after a radical prostatectomy, and using equipment that is readily available for use in privacy at home, resulted in almost all men regaining continence at 6 months.
(Mariotti, 2009)
The Italian research team that conducted the study worked with men who had undergone a radical prostatectomy. Half of the men in the study received twice-weekly pelvic floor electrical stimulation and biofeedback training, starting 7 days after the removal of their catheters and continuing for six weeks. Results showed that they suffered much less urinary incontinence than the other men in the study who were simply told to exercise their pelvic floor muscles.
FOUR weeks after prostate cancer surgery, 63% of the treated men were continent compared with only 30% of the group that were told to exercise. After six months, virtually all of the treated men were continent, compared with only two-thirds of the control group.
The Italian treatment program consisted of two 35 min sessions each week, each consisting of 15 minutes of biofeedback therapy and 20 minutes of electrical stimulation.
In the research study, the treatments were conducted by a clinician. In Australia, a specialist physiotherapist would also be able to provide these treatments. For men who are not within reach of a physiotherapist or other treatment centre, they are also readily self-administered in privacy at home, using quality products available through our online shop.
The Pericalm Pelvic Floor Stimulation Unit is a widely used electrical stimulation device perfect for home use, which can be combined with the Anuform anal electrode to provide the same stimulation as used in the Italian program.
Biofeedback devices include either the PFXA which works on air pressure or the more sophisticated Peritone, which is battery powered and which again can be combined with an Anuform anal electrode.
Men facing, or recovering from, prostate cancer surgery are advised to discuss with their doctor or physiotherapist whether this treatment approach could be right for them. Details below may assist the doctor or therapist to replicate the treatment, or to help their patients implement self-treatment at home.
THE results of this study are extremely encouraging and it is possible that many Australian men undergoing surgery for prostate cancer could benefit from the this treatment program, regardless of where they live and their access to ongoing treatment.
Exactly what treatment methods did Mariotti's study use?
The following extract from the research report describes the treatment methods. Men seeking help with implementing this treatment program may wish to show this extract to their treating doctor or physiotherapist.
"Each of the 12 treatment sessions was homogeneously
composed of a first part with BF (15 minutes)
followed by a second part with FES (20 minutes). Thus,
each session lasted 35 minutes. Patients were placed in a
supine decubitus position. For FES a surface electrode
(InCare™) was inserted into the anus and pulsed at 30 Hz
(first 10 minutes) and 50 Hz (second 10 minutes) square waves at a 300 s pulse duration and a maximal output
current of 24 mA. Stimulation up to the maximal tolerable
level was given. The intensity was adequate to induce
visual lifting of the levator ani and pubococcygeus muscle,
considering the level of comfort of the patient.
For biofeedback a 2-channel electromyographic BF apparatus
(Reactive Biofeedback, BEAC, Stradella, Italy)
was used, with 1 channel for perineal and the other for
abdominal muscles, and the signal received through surface
electrodes.10 During the initial 2 to 3 sessions a
strong emphasis was placed on the specificity of muscle
contraction (contraction of pelvic muscles with minimum
activity of abdominal muscles). During the following sessions,
the exercises were designed to increase the power
and endurance of the pelvic floor muscles. Verbal guidance
of the contractions was also used to instruct the patient
how to correctly continue the exercises at home. Initially
the patients performed these exercises while supine but
later also when sitting or standing, during normal daily
activities."
Mariotti, G and others.
Early recovery of urinary continence after radical prostatectomy using early pelvic floor electrical stimulation and biofeedback associated treatment.
Journal of Urology, 2009 April: 181(4) 1788-93.
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