A randomised controlled study to evaluate the utility and effectiveness of an animated pelvic floor muscle exercise model for patients prior to undergoing radical prostatectomy in improving the ability to correctly perform pelvic floor muscle contraction.

Abstract

INTRODUCTION/BACKGROUND: Performing pelvic floor muscle exercises (PFME) may improve patients' return to urinary continence following radical prostatectomy, however many men find these difficult. This study investigated the use of an animated pelvic floor model to see if it improved men's understanding of the pelvic floor, and their ability to correctly perform a pelvic floor contraction. METHOD: Ethics approval was obtained from Epworth HealthCare and Royal Melbourne Hospital HRECs. Sixty patients from 6 private urology practices, and one public outpatient department, diagnosed with prostate cancer, and scheduled for radical prostatectomy, were recruited. Patients were randomised to receive usual care (verbal and written instruction followed by continence physiotherapist instruction with a prostate cancer DVD), or usual care with the addition of viewing the animated pelvic floor model. Patients completed questionnaires (EPIC-26) to assess continence, a Study Diary to record viewing the study material and PFME performance, and a Satisfaction with PFME Information Received questionnaire. The EPIC-26 questionnaire was sent out for completion again at 1 and 3 months post-operatively. Patients underwent pelvic floor assessment by a blinded continence physiotherapist to assess their ability to correctly perform PFME, before undergoing usual training. RESULTS: Nine patients withdrew from the study leaving 51 evaluable patients. Groups did not differ for age, and EPIC-26 scores. There were no statistically significant differences between the groups ability to correctly perform PFME when assessed by digital rectal examination and transperineal ultrasound x2 (1) = 0.53, p = 0.58. Ninety-five percent of patients viewing the animated pelvic floor model found the information provided "Extremely easy" or "Quite easy" to understand. There were no significant difference in mean urinary incontinence scores at 3 months. CONCLUSION: Despite the negative findings this animated pelvic floor model may assist clinicians in educating patients about PFME, especially where there is limited or no access to continence physiotherapist assessment and instruction.