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Behavioral therapy with or without biofeedback and pelvic floor electrical stimulation for persistent
Patricia S Goode1, Kathryn L Burgio, Theodore M Johnson
1Department of Veterans Affairs, Birmingham–Atlanta Geriatric Research, Education, and Clinical Center, Atlanta, Georgia, USA. pgoode@uab.edu
JAMA
|January 13, 2011
Summary
Behavioral therapy significantly reduced long-term postprostatectomy incontinence episodes in men. Adding biofeedback and electrical stimulation did not improve outcomes, suggesting simpler behavioral therapy is effective for persistent incontinence.
Area of Science:
- Urology
- Pelvic Health
- Clinical Trials
Background:
- Persistent postprostatectomy incontinence affects many men long-term.
- Controlled trials for behavioral therapy in chronic cases were lacking.
Purpose of the Study:
- Evaluate behavioral therapy for persistent postprostatectomy incontinence.
- Assess if biofeedback and electrical stimulation enhance therapy effectiveness.
Main Methods:
- Prospective randomized controlled trial with 208 men (1-17 years post-surgery).
- Compared 8 weeks of behavioral therapy vs. behavioral therapy plus biofeedback/electrical stimulation vs. delayed treatment control.
- Primary outcome: reduction in weekly incontinence episodes via bladder diaries.
Main Results:
- Behavioral therapy reduced incontinence episodes by 55% (28 to 13/week).
- Behavioral therapy plus interventions reduced episodes by 51% (26 to 12/week).
- Both active treatments significantly outperformed the control group (24% reduction), with no significant difference between active treatments.
Conclusions:
- Eight weeks of behavioral therapy effectively reduces persistent postprostatectomy incontinence.
- Adding biofeedback and electrical stimulation does not significantly increase effectiveness.
- Behavioral therapy offers a durable, effective treatment option for long-term postprostatectomy incontinence.