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Effects of Patient Centered Interventions on Persistent Urinary Incontinence after Prostate Cancer Treatment: A Randomized, Controlled Trial

2015; Lippincott Williams & Wilkins; Volume: 194; Issue: 6 Linguagem: Inglês

10.1016/j.juro.2015.07.090

1527-3792

Amy Y. Zhang, Donald R. Bodner, Alex Z. Fu, Douglas D. Gunzler, Eric A. Klein, Denise Kresevic, Shirley M. Moore, Lee Ponsky, Michael Purdum, Gerald Strauss, Hui Zhu,

Urinary Bladder and Prostate Research

No AccessJournal of UrologyAdult Urology1 Dec 2015Effects of Patient Centered Interventions on Persistent Urinary Incontinence after Prostate Cancer Treatment: A Randomized, Controlled Trial Amy Y. Zhang, Donald R. Bodner, Alex Z. Fu, Douglas D. Gunzler, Eric Klein, Denise Kresevic, Shirley Moore, Lee Ponsky, Michael Purdum, Gerald Strauss, and Hui Zhu Amy Y. ZhangAmy Y. Zhang School of Nursing, Case Western Reserve University, Cleveland, Ohio , Donald R. BodnerDonald R. Bodner Department of Urology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio School of Medicine, Case Western Reserve University, Cleveland, Ohio Urology Clinic, Cleveland, Ohio , Alex Z. FuAlex Z. Fu Cancer Prevention and Control Program, Georgetown University Medical Center, Washington, D.C. , Douglas D. GunzlerDouglas D. Gunzler Center for Health Care Research and Policy, Case Western Reserve University, Cleveland, Ohio , Eric KleinEric Klein Glickman Urological and Kidney Institute, Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio , Denise KresevicDenise Kresevic Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio , Shirley MooreShirley Moore School of Nursing, Case Western Reserve University, Cleveland, Ohio , Lee PonskyLee Ponsky Department of Urology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio , Michael PurdumMichael Purdum Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio , Gerald StraussGerald Strauss Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio , and Hui ZhuHui Zhu School of Medicine, Case Western Reserve University, Cleveland, Ohio Urology Clinic, Cleveland, Ohio View All Author Informationhttps://doi.org/10.1016/j.juro.2015.07.090AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We examined whether an intervention combining pelvic floor muscle exercise and symptom self-management would improve urinary continence and quality of life in patients with prostate cancer. Materials and Methods: In a randomized, controlled, longitudinal clinical trial 279 patients with prostate cancer with persistent urinary incontinence were randomized to 1 of 3 groups, including biofeedback pelvic floor muscle exercise plus a support group, the biofeedback exercise plus telephone contact and usual care without intervention. The biofeedback plus support and plus telephone groups received 1 session of biofeedback assisted exercise and 6 biweekly sessions of problem solving therapy. This delivered symptom management skills through a peer support group or telephone contacts for 3 months. All subjects were assessed in blinded fashion at baseline, and 3 and 6 months for urinary leakage frequency, leakage amount and disease specific quality of life. Results: A total of 244 subjects completed the study. The biofeedback plus support and biofeedback plus telephone groups had a lower frequency of daily urinary leakage than the group with usual care without intervention at 3 months (p = 0.019 and p ≤0.001, respectively) but not at 6 months. The biofeedback plus support group but not the biofeedback plus telephone group had 13.3 gm lower leakage at 6 months than the usual care group (p = 0.003). Overall the biofeedback plus support and plus telephone groups reported less symptom severity (p ≤0.001) and fewer incontinence problems (p ≤ 0.01) than the usual care group at 6 months. Conclusions: Study findings show that pelvic floor muscle exercise practice plus symptom self-management in a peer support setting can significantly improve urinary continence and quality of life in patients with prostate cancer. References 1 : 5-year urinary and sexual outcomes after radical prostatectomy: results from the prostate cancer outcomes study. J Urol2005; 173: 1701. 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Volume 194Issue 6December 2015Page: 1675-1681 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordsquality of lifepelvic floorexerciseprostatic neoplasmsurinary incontinenceAcknowledgmentsJohn O'Neill assisted with project management. Neil Casey assisted with data management. Drs. Linien Chien and Nahida Gordon assisted with SAS programming. Matthew McManus provided editorial assistance. The BF technician was trained at Laborie.MetricsAuthor Information Amy Y. Zhang School of Nursing, Case Western Reserve University, Cleveland, Ohio More articles by this author Donald R. Bodner Department of Urology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio School of Medicine, Case Western Reserve University, Cleveland, Ohio Urology Clinic, Cleveland, Ohio More articles by this author Alex Z. Fu Cancer Prevention and Control Program, Georgetown University Medical Center, Washington, D.C. More articles by this author Douglas D. Gunzler Center for Health Care Research and Policy, Case Western Reserve University, Cleveland, Ohio More articles by this author Eric Klein Glickman Urological and Kidney Institute, Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio More articles by this author Denise Kresevic Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio More articles by this author Shirley Moore School of Nursing, Case Western Reserve University, Cleveland, Ohio More articles by this author Lee Ponsky Department of Urology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio More articles by this author Michael Purdum Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio More articles by this author Gerald Strauss Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio More articles by this author Hui Zhu School of Medicine, Case Western Reserve University, Cleveland, Ohio Urology Clinic, Cleveland, Ohio More articles by this author Expand All Advertisement PDF downloadLoading ...