Improving Outcomes After Radical Prostatectomy Using Intensive Pelvic Floor Muscle Training and Trunk Stabilization—A Case Study

Tuesday, October 31, 2023

4:05 PM – 4:11 PM

Location: Station 6

Presenting Author(s)

Susan V. Doherty, PT,DPT (she/her/hers)

Pelvic Floor Physical Therapist
Memorial Hermann Healthcare
Houston, Texas, United States

Non-presenting Author(s)

Jegy M. Tennison, MD

Associate Professor
The University of Texas M D Anderson Cancer Center
Houston, Texas, United States

Research Objectives: To investigate a trunk stabilization intervention using a respiratory muscle trainer tool and intensive pelvic floor muscle training (PFMT) for urinary incontinence and erectile dysfunction refractory to conventional PFMT after radical prostatectomy (RP).

Design: Case Study. Duration: 6 months

Setting: Outpatient pelvic floor rehabilitation clinic in Houston, Texas

Participants: A 57-year-old man with urinary incontinence and erectile dysfunction after radical prostatectomy for localized prostate cancer, refractory to conventional pelvic floor muscle training.

Interventions: A combination of supervised intensive PFMT and trunk stabilization training using a respiratory muscle trainer, “The Breather”,2x/month for 6 months. A home exercise program and behavioral modifications, including bladder training, & engaging pelvic floor muscles pre-movement were also incorporated 7x/week.

Main Outcome Measures: American Urological Association Symptom Score (AUASS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) for lower urinary tract symptoms, subjective report for erectile function defined as full erection or full erection allowing sexual intercourse.

Results: After 6 months of the new regimen, the NIH-CPSI score for lower urinary tract symptoms improved from 12 to 6. After 3 months of treatment, the AUASS score improved from 6 to 4. Erectile function improved at 3 months, with reports of an erection and the ability to have penetrative sexual intercourse by 6 months.

Conclusions: Voluntary trunk stabilization training using a respiratory muscle trainer and high-intensity PFMT improved the course of this patient’s continence and sexual function. Emerging evidence in the literature supports trunk stabilization after RP. Larger studies to examine high-intensity PFMT in conjunction with The Breather are warranted.

Author(s) Disclosures: No disclosure or financial incentives for this author.

Learning Objectives:

Upon completion, participant will be able to describe a novel intervention to train trunk stabilization muscles after radical prostatectomy
Upon completion, participant will be able to list outcome measures suitable to measure progress of supervised pelvic floor muscle training after radical prostatectomy.
Upon completion, participants will be able to summarize how trunk stabilization and supervised pelvic floor muscle training was applied to a clinic case with protracted lower urinary tract symptoms after radical prostatectomy.