Effect of pelvic-floor re-education on duration and degree of incontinence after radical prostatectomy: a randomised controlled trial
Effect of pelvic-floor re-education on duration and degree of incontinence after radical prostatectomy: a randomised controlled trial
复制标题
DOI：
10.1016/s0140-6736(99)03473-x
复制
发表时间：
2000-01-08
期刊：
影响因子：
168.9
通讯作者：
Baert, L
中科院分区：
文献类型：
--
作者：
Van Kampen, M;De Weerdt, W;Baert, L
研究背景尿失禁是前列腺癌根治术后常见的长期并发症。目的探讨盆底再教育对前列腺癌根治术后尿失禁患者的治疗效果。方法对102例前列腺癌根治性耻骨后前列腺癌根治术后尿失禁患者，随机分为治疗组(n=50)和对照组(n=52)。治疗组患者参加盆底再教育计划，只要他们大小便失禁，最长为1年。对照组接受安慰剂治疗。主要终点是3个月时的可控率。治疗组48例，治疗3个月后，43例(88%)患者在治疗3个月后获得可控性。对照组52例患者中，29例(56%)在3个月后恢复可控性。1岁。治疗组与对照组的比例差异为14%(95%可信区间2~27)。治疗组尿失禁持续时间(对数列检验，p=0.0001)和尿失禁程度(wald检验)均有改善。P=0.0010)明显优于对照组，说明盆底再教育应作为根治性前列腺癌术后尿失禁的一线治疗方案。
Background Urinary incontinence is a common long-term complication after radical prostatectomy. Spontaneous recovery of normal urinary control after surgery can take 1-2 years, We aimed to investigate whether there was any beneficial effect of pelvic-floor re-education for patients with urinary incontinence as a result of radical prostatectomy.Methods 102 consecutive incontinent patients who had had radical retropubic prostatectomy for clinically localised prostate cancer and who could comply with the ambulatory treatment schedule in our hospital were randomised, after catheter removal, into a treatment group (n=50) and a control group (n=52). Patients in the treatment group took part in a pelvic-floor re-education programme for as long as they were incontinent, and for a maximum of 1 year. The control group received placebo therapy. The primary endpoint was continence rate at 3 months. Incontinence was assessed objectively with the 1 h and 24 h pad tests and subjectively by the visual analogue scale, The groups were analysed on an intention-to-treat basis by ANOVA and chi(2)-test.Findings In the treatment group continence was achieved after 3 months in 43 (88%) of 48 patients. In the control group, continence returned after 3 months in 29 (56%) of 52 patients. At 1 year. the difference in proportion between treatment and control group was 14% (95% CI 2-27). In the treatment group improvement in both duration (log-rank test, p=0.0001) and degree of incontinence (Wald test. p=0.0010) was significantly better than in the control group.Interpretation Pelvic-floor re-education should be considered as a first-line option in curing incontinence after radical prostatectomy.