Personalized physical therapy reduces incontinence and pain in men after prostate surgery

For decades, the standard treatment for men suffering from urinary incontinence after prostate surgery has been physical therapy aimed at strengthening pelvic muscles. But today, things have changed a bit. A study conducted by experts at UT Southwestern Medical Center, published in International Urology and Nephrology, suggests that such a therapeutic approach might not actually be the most appropriate. In order to study further, the authors of the study analysed the medical charts of patients who had undergone prostatectomies, who were experiencing incontinence due to the surgery and who had followed a physical therapy plan from 2009 to 2014.

The researchers found that, in the majority of patients, the incontinence was not due to weakened muscles but rather to a different condition, a sort of “hyperactivity” characterized by cramps and spasms. In those cases, the exercises meant to strengthen the musculature were not inadvisable as they made the muscles more rigid, but not stronger, explained Michelle H. Bradley, a physiotherapist and co-author of the study. Here are some of the numbers: of the 163 patients analysed, only 25 had weak pelvic muscles; 13 had hyperactive muscles; and 98 had both conditions.

The authors explained that because of the findings, urologists should examine the state of musculature in order to prescribe more appropriate exercises. Exercises for relaxing in cases of hyperactivity, and those for strengthening if cases of weakness, and mixed exercises when both conditions coexist. In any case, the message to take home is - yet again - that every patient is unique and that an individual and “personalized” therapeutic approach is always the better choice.

HFTHQ 20-18