Influence of pre- and post-operative pelvic floor muscle exercises (PFME) on urinary incontinence after retropubic radical prostatectomy and robotic radical prostatectomy.

Prostate cancer is the most common cancer in men on this moment. Radical prostatectomy for localized prostate cancer was always done via retropubic (open) approach. However robotic prostatectomy becomes more and more the treatment of choice. Urinary incontinence and erectile dysfunction are the most embarrassing complications after prostatectomy. Pelvic floor muscle exercises can reduce incontinence and improve erectile function. The purpose of this study is to compare the complications of both surgeries and to evaluate the influence of pelvic floor muscle exercises given before catheter withdrawal.

1. Patients, starting with PFME before radical prostatectomy, have a shorter duration and a lower degree of post-operative urinary incontinence than patients who start with PFME after surgery;

2. Patients, performing pre-operative PFME and PFME during catheter wearing, who develop urinary incontinence, will have a smaller amount of urine loss and urinary incontinence will be reduced more easily compared with patients receiving only exercises after catheter withdrawal;

3. Patients, who had a robotic radical prostatectomy, will restart sooner their pre-operative physical activity level than patients who had a retropubic radical prostatectomy;

4. Patients, who had a robotic radical prostatectomy, will regain urinary incontinence sooner than patients who had a retropubic radical prostatectomy.

1. After 12 months, approximately 120 patients are measured preoperatively and have started their physiotherapeutic treatment;

2. After 18 months, all patients are included in the study and started their physiotherapeutic treatment;

3. After 30 months all patients are being followed until one year after surgery. Data can be processed.

Before surgery (retropubic or robotic) the patient will be randomly assigned to the experimental group, starting PFME before surgery or to the control group, starting PFME after catheter withdrawal.

The pelvic floor muscle training program consists of exercises of the pelvic floor manually controlled by the therapist and supplied with EMG biofeedback and electrostimulation in case of a weak pelvic floor. Every patient receives individual treatment on an outpatient basis once a week. Further the patient performs an exercise scheme independently at home.