Biofeedback cuts urine leak after prostate surgery

For men undergoing prostate removal for prostate cancer, biofeedback training before the surgery reduces the duration and severity of urinary incontinence after the procedure, according to a report in The Journal of Urology.

Behavioral training has been shown to decrease incontinence that persists following prostate surgery, the authors explain, suggesting that training before surgery might also be effective.

Dr. Kathryn L. Burgio and colleagues from the University of Alabama at Birmingham evaluated the effectiveness of pre-op biofeedback to hasten the recovery of urinary control, decrease the severity of incontinence, and improve the quality of life in the 6 months following prostate removal.

The intervention consisted of one session of biofeedback-assisted behavioral training, in which men learned bladder muscle control and received instructions for muscle exercises. A rectal balloon probe measured and provided immediate visual feedback of rectal pressure and bladder muscle control.

Of the 51 men in the biofeedback group, 70 percent reported that they were still doing the exercises they learned preoperatively at the 6-month follow-up.

The time taken to achieve continence in the biofeedback-training group hovered around 3.5 months, the investigators report. On the other hand, fewer than half of the 51 men in the comparison group achieved continence by the 6-month follow-up.

At 6 months, men in the biofeedback group reported an average of 73 days with no leakage, compared with 54 days reported by men in the comparison group.

Severe or continual leakage was still present in nearly 20 percent of comparison subjects at the 6-month mark, the researchers note, compared to 6 percent of those in the biofeedback group.

"The training effect might have been greater had we used more intensive preoperative training or resumed intervention after surgery with a more regular program of postoperative visits to further optimize outcomes," the team suggests.

SOURCE: Journal of Urology, January 2006.