ObjectiveTo assess the effectiveness of pre‐ and postoperative supervised pelvic floor muscle training (PFMT) on the recovery of continence and pelvic floor muscle (PFM) function after robot‐assisted laparoscopic radical prostatectomy (RARP).Patients and MethodsWe carried out a single‐blind randomised controlled trial involving 54 male patients scheduled to undergo RARP. The intervention group started supervised PFMT 2 months before RARP and continued for 12 months after surgery with a physiotherapist. The control group was given verbal instructions, a brochure about PFMT, and lifestyle advice. The primary outcome was 24‐h pad weight (g) at 3 months after RARP. The secondary outcomes were continence status (assessed by pad use), PFM function, and the Expanded Prostate Cancer Index Composite (EPIC) score.ResultsPatients who participated in supervised PFMT showed significantly improved postoperative urinary incontinence (UI) compared with the control group (5.0 [0.0–908.0] g vs 21.0 [0.0–750.0] g; effect size: 0.34, P = 0.022) at 3 months after RARP based on 24‐h pad weight. A significant improvement was seen in the intervention compared with the control group (65.2% continence [no pad use] vs 31.6% continence, respectively) at 12 months after surgery (effect size: 0.34, P = 0.030). Peak pressure during a maximum voluntary contraction was higher in the intervention group immediately after catheter removal and at 6 months, and a longer duration of sustained contraction was found in the intervention group compared with the control group. We were unable to demonstrate a difference between groups in EPIC scores.ConclusionSupervised PFMT can improve postoperative UI and PFM function after RARP. Further studies are needed to confirm whether intra‐anal pressure reflects PFM function and affects continence status in UI in men who have undergone RARP.

中文翻译：

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前列腺切除术中针对节制和肌肉功能的物理治疗：一项随机对照试验

目的评估术前和术后监督盆底肌肉训练（PFMT）对机器人辅助腹腔镜根治性前列腺切除术（RARP）后失禁和盆底肌肉（PFM）功能恢复的有效性。患者和方法我们进行了单盲研究随机对照试验涉及 54 名计划接受 RARP 的男性患者。干预组在 RARP 前 2 个月开始监督 PFMT，并在手术后由物理治疗师继续监督 12 个月。对照组得到口头指示、一本关于 PFMT 的小册子和生活方式建议。主要结果是 RARP 后 3 个月时的 24 小时垫重量 (g)。次要结局是失禁状态（通过尿垫使用评估）、PFM 功能和扩展前列腺癌综合指数 (EPIC) 评分。 结果与对照组相比，参与监督 PFMT 的患者术后尿失禁 (UI) 显着改善 (5.0) [0.0–908.0] g 与 21.0 [0.0–750.0] g 效果大小：0.34，磷= 0.022）在 RARP 后 3 个月基于 24 小时垫重量。术后 12 个月时，与对照组相比，干预组有显着改善（分别为 65.2% 的节制[不使用护垫] vs 31.6% 的节制）（效果大小：0.34，磷= 0.030）。与对照组相比，干预组在拔管后即刻和6个月时最大自主收缩期间的峰值压力较高，并且持续收缩持续时间更长。我们无法证明各组之间的 EPIC 评分存在差异。结论 监督下的 PFMT 可以改善 RARP 后的术后 UI 和 PFM 功能。需要进一步的研究来确认肛门内压力是否反映了 PFM 功能并影响接受 RARP 的男性 UI 的节制状态。