PURPOSE - To examine whether an intervention combining pelvic floor muscle exercise (PFME) and symptom self-management improves urinary continence and quality of life in prostate cancer patients.
MATERIALS AND METHODS - In a randomized, controlled, longitudinal clinical trial, 279 prostate cancer patients with persistent urinary incontinence were randomized to 3 groups: (a) biofeedback PFME plus a support group (BF+SUPPORT), (b) biofeedback PFME plus telephone contact (BF+PHONE), and (c) usual care (UC). The BF+SUPPORT and BF+PHONE groups received 1 session of biofeedback-assisted PFME and 6 biweekly sessions of Problem-Solving Therapy, delivering symptom management skills through a peer support group or telephone contacts over 3 months. All subjects were assessed blind at baseline, 3, and 6 months on urinary leakage frequency, leakage amount, and disease-specific quality of life.
RESULTS - Of the 244 subjects who completed the study, the BF+SUPPORT and BF+PHONE groups had a lower frequency of daily urinary leakage than the UC group at 3 months (p = 0.019, p ≤ .001), but not at 6 months. The BF+SUPPORT group, but not the BF+PHONE group, had a lower leakage amount at 6 months than the UC group, by 13.3 grams (p = 0.003). Overall, the BF+SUPPORT and BF+PHONE groups reported less symptom severity (p ≤ .001) and fewer incontinence problems (p ≤ 0.01) than the UC group at 6 months.
CONCLUSIONS - The study findings show that PFME practice plus symptom self-management in a peer support setting can significantly improve urinary continence and quality of life of prostate cancer patients.
TRIAL REGISTRATION - clinicaltrials.gov Identifier: NCT01365182.
J Urol. 2015 Jul 28. pii: S0022-5347(15)04498-5. doi: 10.1016/j.juro.2015.07.090. [Epub ahead of print]
Zhang AY1, Bodner DR2, Fu AZ3, Gunzler DD4, Klein E5, Kresevic D6, Moore S7, Ponsky L8, Purdum M9, Strauss G10, Zhu H11.
1 Case Western Reserve University School of Nursing, 10900 Euclid Avenue, Cleveland, OH 44106-4904.
2 Case Western Reserve University School of Medicine; University Hospitals of Cleveland, Department of Urology, 19019 Euclid Avenue, Cleveland, OH 44106; Case Western Reserve University School of Medicine; Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Urology Clinic, 10701 East Blvd., Cleveland, OH 44106.
3 Cancer Prevention and Control Program, Georgetown University Medical Center, 3300 Whitehaven Street NW, Suite 4100 - Milton Harris Bldg., Washington, DC 20007.
4 Case Western Reserve University School of Medicine; Center for Health Care Research and Policy, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109-1998.
5 Glickman Urological and Kidney Institute, Cleveland Clinic Lerner College of Medicine, Desk Q10-1, 9500 Euclid Ave, Cleveland, OH 44195.
6 Louis Stokes Cleveland Department of Veterans Affairs Medical Center, 10701 East Blvd., Cleveland, OH 44106.
7 Case Western Reserve University School of Nursing, 10900 Euclid Avenue, Cleveland, OH 44106-4904.
8 Case Western Reserve University School of Medicine; University Hospitals of Cleveland, Department of Urology, 19019 Euclid Avenue, Cleveland, OH 44106.
9 Louis Stokes Cleveland Department of Veterans Affairs Medical Center, 10701 East Blvd., Cleveland, OH 44106.
10 Louis Stokes Cleveland Department of Veterans Affairs Medical Center, 10701 East Blvd., Cleveland, OH 44106.
11 Case Western Reserve University School of Medicine; Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Urology Clinic, 10701 East Blvd., Cleveland, OH 44106.