Biofeedback cuts urine leak after prostate surgery

NEW YORK (Reuters Health) – For men undergoing prostate
removal for prostate cancer, biofeedback training before the
surgery reduces the duration and severity of urinary
incontinence after the procedure, according to a report in The
Journal of Urology.

Behavioral training has been shown to decrease incontinence
that persists following prostate surgery, the authors explain,
suggesting that training before surgery might also be
effective.

Dr. Kathryn L. Burgio and colleagues from the University of
Alabama at Birmingham evaluated the effectiveness of pre-op
biofeedback to hasten the recovery of urinary control, decrease
the severity of incontinence, and improve the quality of life
in the 6 months following prostate removal.

The intervention consisted of one session of
biofeedback-assisted behavioral training, in which men learned
bladder muscle control and received instructions for muscle
exercises. A rectal balloon probe measured and provided
immediate visual feedback of rectal pressure and bladder muscle
control.

Of the 51 men in the biofeedback group, 70 percent reported
that they were still doing the exercises they learned
preoperatively at the 6-month follow-up.

The time taken to achieve continence in the
biofeedback-training group hovered around 3.5 months, the
investigators report. On the other hand, fewer than half of the
51 men in the comparison group achieved continence by the
6-month follow-up.

At 6 months, men in the biofeedback group reported an
average of 73 days with no leakage, compared with 54 days
reported by men in the comparison group.

Severe or continual leakage was still present in nearly 20
percent of comparison subjects at the 6-month mark, the
researchers note, compared to 6 percent of those in the
biofeedback group.

“The training effect might have been greater had we used
more intensive preoperative training or resumed intervention
after surgery with a more regular program of postoperative
visits to further optimize outcomes,” the team suggests.

SOURCE: Journal of Urology, January 2006.