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Pelvic floor muscle training before transurethral resection of the prostate: a randomized, controlled, blinded study
Tibaek S, Klarskov P, Hansen BL, Thomsen H, Andresen H, Jensen CS, Olsen MN
Scandinavian Journal of Urology and Nephrology 2007 Sep;41(4):329-334
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To evaluate the effect of preoperative pelvic floor muscle training (PFMT) in men scheduled for transurethral resection of the prostate (TURP) in a randomized, single-blind study. MATERIAL AND METHODS: Fifty-eight men with benign prostatic obstruction were included, and 49 completed the study (training group, n = 26; control group, n = 23). The preoperative training included a 1-h individual lesson, three 1-h group lessons and a home training programme. Postoperatively and before discharge from hospital both groups received verbal instructions regarding PFMT. Pelvic floor muscle function was assessed by anal examination before and 4 weeks after surgery by one physiotherapist who was blinded to the randomization. The primary outcome parameter was the total score on the Danish Prostatic Symptom Score questionnaire. Secondary outcome measures were other subjective and objective voiding and incontinence parameters and four tests of the pelvic floor muscle: function; strength; static endurance; and dynamic endurance. RESULTS: Baseline characteristics were similar in the two groups. Improved static endurance occurred in the training group but not in the control group (p = 0.004). Regarding dynamic endurance, a difference in favour of training developed between the groups (p = 0.049). Many men produced results that were outside the test scales. At follow-up at 2 and 4 weeks and 3 months there were no differences between the groups in any of the lower urinary tract parameters. CONCLUSION: Preoperative PFMT produced a significant improvement in pelvic floor muscle endurance after TURP, but clinically relevant storage or voiding improvements did not occur. Pelvic floor muscle assessment tests need to be sex-specific.

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