Integrative Physical Therapy Versus Pelvic Floor Muscle Training for Post-Prostatectomy Stress Urinary Incontinence: A Randomized Controlled Trial

Mohammad  Sheibanifar; Zahra  Ebrahimabadi; Hoda  Niknam; Farshad  Okhovatian; Alireza Akbarzadeh  Baghban; Marzieh  Mortezanejad

doi:10.18502/jmr.v20i2.21712

Mohammad Sheibanifar Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Zahra Ebrahimabadi Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Hoda Niknam Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Farshad Okhovatian Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Alireza Akbarzadeh Baghban Department of Biostatistics, Proteomics Research Center, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Marzieh Mortezanejad Department of Physiotherapy, School of Rehabilitation Sciences, Semnan University of Medical Sciences, Semnan, Iran.

DOI: https://doi.org/10.18502/jmr.v20i2.21712

Keywords: Pelvic floor muscle training; Electrical stimulation; Urinary incontinence; Prostatectomy; Quality of life

Abstract

Introduction: Post-prostatectomy stress urinary incontinence (PPSUI) is a common complication of radical prostatectomy. This study aimed to compare the efficacy of integrative physical therapy (IPT) and supervised pelvic floor muscle training (PFMT) in managing PPSUI.

Materials and Methods: Sixty-six men aged 50–80 years with PPSUI were randomly assigned to IPT, PFMT, or control groups. The IPT program included electrotherapy, manual therapy, diaphragmatic breathing, and PFMT. The PFMT group received supervised PFMT. The control group received a sham form of electrotherapy. All interventions were delivered in 12 sessions over four weeks. Outcome measures included voided volume, fluid intake, micturition frequency, incontinence frequency, and health-related quality of life (QoL), assessed using the 12-item short-form (SF-12) questionnaire.

Results: Both IPT and PFMT significantly reduced micturition and incontinence frequency and improved SF-12 scores compared with the control group (P<0.001). The control group showed no significant improvements across any outcome measures. IPT demonstrated superior improvements relative to PFMT in micturition frequency, incontinence frequency, and SF-12 scores (P<0.05).

Conclusion: IPT and PFMT are effective for PPSUI, with IPT showing greater overall efficacy.