Introduction. The high prevalence of prostate surgical interventions leads to an increase of stress urinary incontinence (SUI) of varying severity. SUI leads to a significant decrease of quality of life, sleep disorders, and the appearance of clinically pronounced signs of anxiety and depression. The main methods of SUI treating in men are sling surgery and artificial sphincter implantation. However, treatment can lead to postoperative complications and has several contraindications. Also, many patients, after undergoing surgery, try to refrain from subsequent corrective surgery. Minimally invasive methods of treatment of SUI in men (introduction of bulking agents, behavioral therapy, Kegel exercises) have low efficiency. All this determines the need to search for new methods of treatment, including personalization of pelvic floor muscle training.
Materials and methods. The study included 37 patients with SUI after radical prostatectomy (RPE) or transurethral resection of prostate (TURP). In all patients, the presence of SUI was confirmed urodynamically. All patients passed standardized examination, which included: uroflowmetry (UFM), complex urodynamic study (on the first visit). One hour psd-test and questionares were also evaluated at each visit: a visually analog scale (VAS) of the quality of life associated with urinary incontinence; a sleep quality assessment scale; hospital scale of anxiety and depression. All patients underwent 5 months of pelvic floor muscle training by portable system «kGoal BOOST» with an assessment of the dynamics of their condition at 1 and 5 months of training.
Results. All patients were divided into two groups: Group I – 21 patients (56.7%) with SUI after RPE, and Group II – 16 patients (43.3%) with SUI after TURP. According to the UFM data, at the 5-month training mark, an increase in voided volume was observed in patients from both groups: 34.1% in Group I and 15.2% in Group II. Additionally, at the same time, a significant improvement in one hour pad-test was seen in all patients, with Group I showing a 81.5% decrease and Group II showing an 85.7% decrease. At 5 months, VAS assessment revealed a significant improvement in quality of life for both groups, with Group I improving by 141.8%, Group II by 112.2%, and a clinically significant reduction in anxiety (-27.6% in Group I, -42.9% in Group II) and depression (-15.3% in Group I, -18.2% in Group II). It is important that there was a significant improvement in sleep quality indicators after the third visit for patients in both groups. The improvement was 36.4% for group I and 60.3% for group II.
Conclusion. The study confirmed the effectiveness of personal portable trainer with feedback function to train the pelvic floor muscles in mild to moderate SUI in men. Its makes significantly and reliably reduce the amount of urine lost, reduces the manifestations of anxiety and depression, improves sleep and, as a result, improves the patient’s quality of life.
