Male Urinary Incontinence

Abstract

The aim of the current study was to determine the demographic characteristics and risk factors associated with male urinary incontinence (UI) and to assess the effectiveness and the effect on the quality-of-life of a pelvic floor muscle training (PFMT) protocol with electromyography-biofeedback (EMG-BFB) with surface electrodes. A prospective, quasi-experimental before-and-after study with a sample of 61 men out of 372 patients referred to the Pelvic Floor Unit from October 2005 to June 2012 was performed. The protocol consisted of 20 sessions of EMG-BFB supervised by a physiotherapist twice a week. The session durations were 30 minutes (118 work/rest cycles of pelvic muscles). Work lasted 3 seconds and rest 7 seconds. Patients were given standards of conduct and questionnaires (International Consultation on Incontinence-Short Form and Incontinence Quality-of-Life Measure) at the beginning and at the end of the treatment. The average age was 64.85 ± 14.34 years; 44.3% (n = 27) had benign prostatic hypertrophy, 41.9% (n = 25) had prostate malignant neoplasm, 86.9% (n = 53) had undergone prostatectomy, 16.4% (n = 10) had undergone abdominal surgery. Abdominal surgery and radical prostatectomy were significantly associated with UI (p < .05). Stress urinary incontinence was the most common type of UI (86.67%), followed by mixed urinary incontinence (8.33%) and urge urinary incontinence (5%). A significant improvement (p < .05) in both International Consultation on Incontinence-Short Form and Incontinence Quality-of-Life Measure questionnaires was observed when making comparisons regarding the results before and after the EMG-BFB treatment protocol. These results support that male UI is significantly associated with urological and abdominal surgery (including radical prostatectomy) and that EMG-BFB for PFMT improves incontinence and quality of life (social embarrassment, limiting behavior, and psychosocial impact) in the three types of UI on an overall basis. Keywords prostate cancer, male incontinence, health-related quality of life

Manometric Biofeedback Effectiveness on Urinary Incontinence and Quality of Life: A Non-Randomized Control Trial

“…On the contrary, EMG-biofeedback is the most used technique to treat urinary incontinence (5)(6)(7).…”

“…It is scored from 0 to 21; the higher the score, greater the severity (Table 1) (5,6). A score of 21 corresponds to total incontinence, while a score of 0 reflects complete continence (5,6). The I-QOL specifically measures the QoL in UI.…”

“…Urinary incontinence may be defined according to patient's symptoms as: 1) stress UI (SUI) as the complaint of involuntary leakage on effort or exertion, or on sneezing Conservatives modalities include bladder training (based on voiding dairy), lifestyle recommendations, pelvic floor muscle training (PFMT), manometric or electromyography (EMG), biofeedback (BFB), and pharmacotherapy (1,5,6). Surgical treatment includes slings, bulking agents, colposuspension, bladder augmentation, and sacral neuromodulation (1,5,6).…”

“…Surgical treatment includes slings, bulking agents, colposuspension, bladder augmentation, and sacral neuromodulation (1,5,6). An intermediate alternative is peripheral percutaneous neuromodulation (5).…”

“…For a better interpretation, it is transformed to a scale from 0 to 100. The I-QOL is divided to 3 subscales: limitation of activity or behavior (LB) with 8 items, psychosocial Impact (PI) with 9 items, and social embarrassment (SE) with 5 items (Table 2) (5,6).…”