Urology as rehabilitation medicine: a literature review

Abstract

As a urologist, we usually encounter with two representative functional behaviors, namely, voiding and sexual function. These are not only important but also complex and synchronized so if these functions are impaired, patients need active functional rehabilitation to recover. These functional impairments should be recognized and corrected early because they could not only cause direct damage to the affected functions but also have harmful consecutive consequences such as kidney damage due to voiding abnormality and self-esteem damage due to decreased sexual function. Numerous rehabilitative methods are currently available, which help minimize the negative effects of these functional impairments. In terms of voiding function, pelvic floor muscle exercise, biofeedback, functional magnetic stimulation, neuromodulation, and clean intermittent self-catheterization are representative rehabilitation modalities. In case of children, extra-attention should be paid because this might affect their entire life. In impairment of sexual function, early intervention to maintain male erection is the main target of rehabilitation to prevent corporal fibrosis and penile deformity and increase recovery chance in patients who underwent radical prostatectomy or major surgery. In this review, we will elucidate various rehabilitation methods in urology to further increase our understanding of the rehabilitative characteristics of urology and widen our view of rehabilitation medicine.

Management of treatment‐related sequelae following colorectal cancer

“…Moreover, concomitant biofeedback could synergistically reinforce the pelvic floor muscle exercise [137] (1b). Another first-line treatment option is bladder training, wherein scheduled voiding is used to eliminate pollakiuria and/or urinary incontinence [138] (5).…”

“…A small prospective series in 45 RC survivors (29 men) showed great reversibility in urinary incontinence (stress incontinence) after early initiation of pelvic floor muscle exercise [127] (2b). Moreover, concomitant biofeedback could synergistically reinforce the pelvic floor muscle exercise [137] (1b). Another first‐line treatment option is bladder training, wherein scheduled voiding is used to eliminate pollakiuria and/or urinary incontinence [138] (5).…”

Grand Challenge in Medical and Surgical Rehabilitation: From Mechanisms to Evidence Based Rehabilitation Programs

“…• Bladder and prostate surgery are other examples of the need for surgical rehabilitation. A number of post-surgical symptoms have a high impact on the patient's quality of life (18). These range from incontinence, external urination systems, sexual dysfunction, fatigue, and mental health problems (19).…”

Ressecção anterior do reto vs prostatectomia radical. Existem diferenças na reabilitação sexual?

“…To break this vicious cycle, the concept of early intervention was first described by Montorsi et al 14 . The treatment options include: phosphodiesterase-5 inhibitors (PDE5I) scheduled or daily dosing; alprostadil preparations (injectables or urethral pellets) and vacuum constriction devices 15,16 . These interventions have been used singly or in combination, after successful trials without catheterization following surgery 16 .…”