Comparison of In-person Versus Online Comprehensive Pelvic Floor Rehabilitation Program Following Prostatectomy

Area of Science:

• Urology
• Rehabilitation Medicine
• Digital Health

Background:

• Urinary incontinence (UI) is a common complication following prostatectomy.
• Pelvic floor muscle training (PFMT) and pelvic floor education (PFE) are effective for managing post-prostatectomy UI.
• Access to supervised in-person PFMT/PFE (iPFMT/PFE) can be limited by various barriers.

Purpose of the Study:

• To compare the effectiveness of supervised in-person PFMT/PFE (iPFMT/PFE) versus an online PFMT/PFE (oPFMT/PFE) program for improving continence outcomes in men post-prostatectomy.
• To evaluate the feasibility and accessibility of a novel online program for PFMT/PFE delivery.

Main Methods:

• A retrospective review of 41 men who underwent robotic-assisted laparoscopic prostatectomy (RALP) and participated in either iPFMT/PFE or oPFMT/PFE.
• Outcomes including UI (ICIQ-MLUTS SUI domain score - SDS), daily pad use (PPD), and quality of life (QOL - IIQ-7) were assessed at multiple time points up to 12 months post-surgery.
• Primary outcome was the change in SDS; secondary outcomes included PPD cure, SUI cure, and QOL scores.

Main Results:

• Both iPFMT/PFE and oPFMT/PFE groups showed significant improvements in UI and QOL over 12 months.
• While oPFMT/PFE group had slightly lower SDS scores at some time points, the rate of improvement was similar between groups.
• There were no significant differences in SUI cure rates (75% oPFMT/PFE vs. 60% iPFMT/PFE) or PPD and QOL scores between the two groups at 12 months.

Conclusions:

• Supervised in-person and online pelvic floor muscle training and education programs yield comparable significant improvements in urinary incontinence and quality of life for men after prostatectomy.
• The developed online program offers a viable and accessible alternative for PFMT/PFE delivery, potentially overcoming access barriers for patients undergoing robotic-assisted laparoscopic prostatectomy.