Behavioral therapy program reduces post-RP incontinence

Participation in a behavioral training program for at least 1 year following radical prostatectomy reduced the number of incontinence episodes in men in a recently published study.

The addition of biofeedback and pelvic floor electrical stimulation provided no additional benefit, according to the authors, led by Patricia S. Goode, MD, of the University of Alabama at Birmingham, and colleagues from the Birmingham/Atlanta Veterans Affairs Geriatric Research, Education and Clinical Center and Emory University, Atlanta.

The randomized controlled trial, which involved 208 community-dwelling men ages 51 through 84 years with incontinence persisting 1 to 17 years after radical prostatectomy, was conducted from 2003 to 2008. Twenty-four percent of the men were African-American; 75% were Caucasian. Participants were randomized to 8 weeks of behavioral therapy; behavioral therapy plus in-office, dual-channel electromyograph biofeedback and daily home pelvic floor electrical stimulation (behavior-plus group); or delayed treatment (controls).

The researchers found that at 8 weeks, those in the behavioral therapy group had an average reduction of incontinence episodes of 55% percent compared with 24% in the control group. Those in the behavior-plus group experienced an average reduction of 51%.

At the end of the 8-week treatment period, 15.7% of men in the behavior therapy group, 17.1% in the behavior-plus group, and 5.9% in the control group achieved complete continence, reporting no incontinence episodes in their 7-day bladder diaries.

"Our findings indicate that no matter how long it's been since surgery, behavioral interventions can help men reduce the number of incontinent episodes they experience," Dr. Goode said. "There is no guarantee that they’ll be completely dry, but behavioral therapy will help reduce incontinence and improve quality of life."

Results from the study were published in JAMA (2011; 305:151-9).