Neoplasms

Urinary Tract, Sexual Organs, and Pregnancy Conditions

All Conditions

Symptoms and General Pathology

Behaviors and Mental Disorders

Prostatic Neoplasms

Urinary Incontinence

Enuresis

Nocturnal Enuresis

Urogenital Diseases

Male Urogenital Diseases

Urination Disorders

Urologic Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Lower Urinary Tract Symptoms

Urological Manifestations

Behavioral Symptoms

Elimination Disorders

Mental Disorders

Psychotic Disorders

Weekly Pilates sessions, guided by a specialized physiotherapist. The duration of the treatment was 10 weeks, and each session lasted 45 to 50 minutes. All subjects received instruction to perform specific daily home exercises.

For also 10 weeks, the participants went trough anal electrical stimulation associated with Pelvic Floor Muscle Training, supervised by a specialized physiotherapist. All subjects received orientation to perform the same pelvic floor exercises at home.

PILATES

PFMT and AES

The purpose of this study is to compare the efficacy between a Pilates exercise program and a Pelvic Floor Muscle Training (PFMT) protocol combined with anal electrical stimulation (AES) in the recovery of urinary continence (UI) after radical prostatectomy.

There are no studies that evaluate Pilates mat exercises for incontinence in men although it can be assured that this method has the pelvic floor contractions as a principle for practice. If this new therapeutic approach proves to be as effective as described treatment in improving urinary complaints, it will be an option for patients who prefer a non-invasive treatment.

This randomized clinical trial includes 69 individuals with urinary incontinence one month after radical prostatectomy. One physiotherapist, with experience in urogynecology, was responsible for all the assessments. Urinary frequency, nocturia, 24-hour pad test, number of pads used per day, and the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) were the variables evaluated.

The subjects were allocated in one of two treatment groups (G1: Pilates; G2: anal electrical stimulation combined with pelvic floor muscle training). Volunteers participated of 10 sessions of the corresponding treatment and were reassessed objectively by the number of pads used per day, and subjectively with the score of quality of life.

The Efficacy of Pilates in the Recovery of Post-prostatectomy Urinary Incontinence

The Efficacy of Pilates Compared to Pelvic Floor Muscle Training Associated With Electrical Stimulation in the Recovery of Post-prostatectomy Urinary Incontinence: a Randomized Clinical Trial.

Universidade Estadual de Londrina

Physioterapist student of a masters degree program at the Center of Health Science

Vattikuti Urology Institute radical prostatectomy da Vinci Surgical System

Retzius sparing radical prostatectomy da Vinci Surgical System

Robotic assisted laparoscopic radical prostatectomy based on Retzius sparing technique

Retzius sparing radical prostatectomy

Robotic assisted laparoscopic radical prostatectomy based on Vattikuti Urology Institute technique

Vattikuti Urology Institute radical prostatectomy

The da Vinci Surgical System is a sophisticated robotic platform designed to expand the surgeon's capabilities and offer a state-of-the-art minimally invasive option for major surgery.

da Vinci Surgical System

Mani Menon, MD

To assess and compare the short-term post-operative continence recovery rate in two cohorts of men undergoing Robot Assisted Radical Prostatectomy (RARP), each randomized to undergo RARP with Vattikuti Institute technique or Retzius sparing technique.

Traditionally, RARP is performed using a trans-peritoneal technique that pass anteriorly to the bladder. This technique necessitates the dissection and/or manipulation of many structures, which might compromise post-operative urinary continence recovery. These structures include the pubo-prostatic ligament, Santorini plexus, neurovascular bundle, and veil of Aphrodite. Recently, a "Retzius-sparing" technique to perform RARP has beed described. This approach passes posteriorly to the bladder, through the space of Douglas, which should minimize the damaged to the aforementioned structure. Theoretically, the latter technique should improve post-operative urinary continence recovery. However, a randomized comparison between the "traditional" RARP and "Retzius-sparing" RARP is still lacking.

Impact of Robot-assisted Radical Prostatectomy Technique on Short-term Continence Recovery

The Impact of Retzius-sparing Approach for Robot-assisted Laparoscopic Radical Prostatectomy on Short-term Continence Recovery: Randomized Controlled Trial

MSKCC (Memorial Sloan Kettering Cancer Center) STAR questionnaire (symptom tracking and reporting). Score ranges from 0-25, with higher scores indicating better urinary function

SHIM ranges from 0-25 with higher scores indicating better sexual function; a score of \>=22 is normal and \>=17 is considered mild ED

Patients without biochemical evidence of disease recurrence (i.e. postop PSA \>=0.2 ng/mL)

International Prostatic Symptom Score (continuous score from 0-35, higher scores indicating worse urinary function)

Henry Ford Health System

Director, Vattikuti Urology Institute

Vattikuti Urology Institute radical prostatectomy da Vinci Surgical System

Vattikuti Urology Institute radical prostatectomy: Robotic assisted laparoscopic radical prostatectomy based on Vattikuti Urology Institute technique

da Vinci Surgical System: The da Vinci Surgical System is a sophisticated robotic platform designed to expand the surgeon's capabilities and offer a state-of-the-art minimally invasive option for major surgery.

Control Arm

Retzius sparing radical prostatectomy da Vinci Surgical System

Retzius sparing radical prostatectomy: Robotic assisted laparoscopic radical prostatectomy based on Retzius sparing technique

da Vinci Surgical System: The da Vinci Surgical System is a sophisticated robotic platform designed to expand the surgeon's capabilities and offer a state-of-the-art minimally invasive option for major surgery.

Treatment Arm

Total

Age, Continuous

Sex: Female, Male

preoperative prostate specific antigen level

International Prostatic Symptom Score (IPSS) objectively assesses urinary symptoms. It ranges from 0 to 35, with higher scores indicating worse urinary symptoms

preoperative IPSS score

SHIM (Sexual Health Inventory for Men) objectively asses sexual function. It ranges from 0-25, with higher scores indicating better sexual function.

preoperative SHIM score

NCCN (National Comprehensive Cancer Network) risk categorizes prostate cancer based on their likelihood of disease progression, recurrence and outcomes, into low, intermediate, high and very high risk groups. It uses clinical information (i.e information available PRIOR to surgery) for this (i.e PSA, biopsy gleason score and clinical T stage)

NCCN clinical risk

Deepansh Dalela, MD

Urinary Continence Recovery

Number of Participants With Urinary Continence Recovery

Number of Participants With Peri and Postoperative Complications

Number of Participants Who Regained Potency Postoperatively (as Measured by Sexual Health Inventory for Men (SHIM) Score of 17 or Greater)

Number of Participants Who Had Biochemical Recurrence (Post-operative Prostate-Specific Antigen (PSA) Value >=0.2 ng/ml)

Post-operative Urinary Function and Urinary Function-related Quality of Life

Number of Patients Who Regained Urinary Continence Postoperatively

The numbers in this analyses are different from the primary analyses as some patients were lost to follow up (by one year)

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
The Efficacy of Pilates in the Recovery of Post-prostatectomy Urinary Incontinence	NCT02086266	Prostate Cancer Urinary Inconti...	PILATES PFMT and AES	50 Years - 75 Years	Universidade Estadual de Londrina
Impact of Robot-assisted Radical Prostatectomy Technique on Short-term Continence Recovery	NCT02352103	Urinary Inconti...	Retzius sparing... Vattikuti Urolo... da Vinci Surgic...	40 Years - 75 Years	Henry Ford Health System

Spots Global Cancer Trial Database for urinary continence