Efficacy of Rehabilitation Program with Visual and Auditory Biofeedback for Urinary Incontinence and Quality of Life after Robot-Assisted Radical Prostatectomy

Masataka Kamiya, Naohito Morishima, Yasuhiro Terashima, Takuya Tani, Takami Furuhashi
Purpose:

This retrospective study assessed the efficacy of a rehabilitation program with visual and auditory biofeedback on postoperative urinary incontinence and QOL.

Methods:

A total of 32 patients who underwent RARP at Toyohashi Municipal Hospital were included: 14 in the control group (pamphlet guidance) and 18 in the rehabilitation group (pamphlets, echo, and DI belt). Postoperative urinary incontinence was defined as the use of more than 2 incontinence pads (20g) per day (previous studies defined the self-reported use of a small pad [20g] per day as an indicator of continence recovery after RARP). QOL was evaluated using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Guidance for use of the echo and DI belt was provided by a physical therapist during hospitalization (one 10-minute echo session the day before surgery, two 10-minute DI belt sessions the day before surgery and at discharge). Patients practiced sit-to-stand movements with the DI belt to keep pelvic floor muscle contractions and awareness of abdominal pressure changes. The DI belt was lent out for 1 month postoperatively with instructions to wear it for 1 hour each in the morning and afternoon (2 hours/day). The study was designed as a case-control study. To assess the risk of postoperative urinary incontinence at 1 month, we calculated the odds ratio (rehabilitation/control). The Mann-Whitney U test was used to compare the median ICIQ-SF scores. The significance level was set at p0.05. 

Results:

At 1 month postoperatively, 13 of 14 control group cases and 9 of 18 rehabilitation group cases exhibited urinary incontinence. The odds ratio was 0.077 (95% confidence interval, 0.008-0.718), indicating a significant difference between groups (p0.05). The median ICIQ-SF score significantly differed between the control group (16, range 6-21) and the rehabilitation group (10, range 1-18; p0.05). 

Conclusion(s):

This rehabilitation program incorporating both visual and auditory biofeedback was associated with a reduction in urinary incontinence risk and improvement in QOL at 1 month after RARP. 

Implications:

The involvement of physical therapists with specialized knowledge is essential for facilitating early recovery of urinary continence and improving QOL following RARP.

Funding acknowledgements:
This study was unfunded.
Keywords:
Rehabilitation Program
Quality of Life
Robot-Assisted Radical Prostatectomy
Primary topic:
Pelvic, sexual and reproductive health
Second topic:
Health promotion and wellbeing/healthy ageing/physical activity
Third topic:
Disability and rehabilitation
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
This study was approved by the Toyohashi Municipal Hospital Ethics Committee. Written informed consent was obtained from all patients.
Provide the ethics approval number:
Number 707
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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