Functional outcomes of a biofeedback-guided pelvic floor muscle training program following robot-assisted radical...

Urinary incontinence remains one of the main functional sequelae after robot-assisted radical prostatectomy (RARP). This study aimed to evaluate urinary continence and functional outcomes in patients enrolled in a structured postoperative pelvic floor muscle training program with biofeedback.

We conducted a single-centre retrospective observational study including consecutive patients who underwent RARP between November 2024 and October 2025 and entered a postoperative biofeedback-guided pelvic floor rehabilitation program, with a minimum follow-up of 3 months. Patients with previous pelvic radiotherapy, preoperative urinary incontinence or incomplete key data were excluded. Biofeedback was started 12-14 days after hospital discharge, coinciding with catheter removal, and included 3-4 supervised sessions according to clinical progress, together with a home exercise program. The primary outcome was urinary continence, defined as the use of 0-1 pad/day, at 3 and 6 months after surgery.

Ninety patients were included. Mean age was 64.4 ± 6.3 years and mean body mass index was 29.1 ± 4.3 kg/m². Continence rates were 88.9% at 3 months and 94.4% at 6 months. Lower 24-h pad test values were significantly associated with continence at the first and second follow-up visits (both p < 0.001). No significant associations were found between 3-month continence and age, body mass index, preoperative PSA, prostate volume or catheterisation time. Nevertheless, the number of biofeedback sessions was significantly associated with continence recovery, suggesting a possible dose-response effect.

A structured postoperative pelvic floor rehabilitation program with biofeedback was associated with high rates of early continence recovery after RARP. The intensity of supervised rehabilitation may influence functional recovery. Prospective controlled studies are warranted to confirm these findings.