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Behavioral Therapy Reduces Incontinence After Surgery

Pelvic floor muscle exercises and other control strategies helpful after prostatectomy

TUESDAY, Jan. 11 (HealthDay News) -- Behavioral therapy may help to significantly reduce persistent postprostatectomy incontinence, according to a study published in the Jan. 12 issue of the Journal of the American Medical Association.

Patricia S. Goode, M.S.N., M.D., from the University of Alabama in Birmingham, and colleagues analyzed data from a prospective randomized controlled trial involving 208 men suffering from incontinence one to 17 years after radical prostatectomy. Patients were randomly allocated to one of the following three groups: eight weeks of behavioral therapy (pelvic floor muscle training plus strategies for bladder control); behavioral therapy plus dual-channel electromyograph biofeedback and daily pelvic floor electrical stimulation (behavior plus); or a delayed treatment control group.

The investigators found that mean incontinence episodes decreased from 28 to 13 per week for those in the behavioral therapy group, and from 26 to 12 episodes for those in the behavior plus therapy group. These reductions were significantly higher than for the control group. Improvements lasted for 12 months in both treatment groups: incontinence reduction was 50 percent in the behavior group and 59 percent in the behavior plus group (P = .32).

"Behavioral therapy, including pelvic floor muscle exercises, bladder control strategies, fluid management, and self-monitoring with bladder diaries is an effective treatment for postprostatectomy incontinence persisting more than one year after surgery," the authors write.

Several of the study authors disclosed financial ties with medical device and pharmaceutical companies.

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