BPH 09. Pelvic floor biofeedback in the treatment of urinary incontinence after TURP

Objectives: To investigate the effectiveness and advantages of pelvic floor biofeedback therapy applied to treat urinary incontinence after transurethral resection of the prostate (TURP).

Methods: 24 cases of urinary incontinence after TURP were treated by biofeedback, pelvic floor stimulation. The patients whose average age was 59 all underwent TURP, and urinary incontinence after surgery had lasted for 2 weeks to six months. There were 15 cases of mild incontinence: involuntary release of urine only a few milliliters at a sharp, sudden increase in intra-abdominal pressure, sneezing or laughing); 7 cases of moderate incontinence: clinical symptom appear during breath holding or exertion; 2 cases of severe incontinence: loss of urine in stationary position (standing but not sitting). The anal working electrode was inserted into the anus with the patients in lateral position, The insertion depth of the working electrode was adjusted to make sure that the surface electrode located in the perianal region, and set the stimulation parameters to the excitement that without pain to the patients, stimulation duration was 10 s every time. The patients were instructed to contract pelvic floor muscle immediately during feedback, and to relax before the next stimulus. The exercise of pelvic floor muscle contraction and relaxation was carried out alternately. Each treatment lasted for 20 minutes and was performed twice a day, 5 days a week, 1-3 months as a course. At the intermittent period and after the termination of the therapy, the patients were required to do pelvic floor muscles exercise approximately 300 times and to carry out the exercise 3 times a day.

Results: After 2-3 months of therapy, no urinary incontinence was perceived by 22 patients of mild and moderate incontinence. The therapies of 2 cases of severe incontinence were extended to 6 months. Comparison of the detection of urodynamic leak point pressure between pre and post treatment showed statistically difference (P<0.05).

Conclusions: To strengthening the pelvic floor muscle function and improve the stability of detrusor is an important way to treat urinary incontinence. Electrical stimulation of the pelvic floor muscles can inhibit the contraction of bladder, and is of positive treatment value in unstable bladder and urge incontinence. Furthermore, it can increase the contraction of urethral sphincter and strengthen the function of urethral closure. Pelvic floor electrical stimulation is a safe and effective therapy for urinary incontinence after TURP.