What’s new in preventing and treating post-operative incontinence after prostate cancer

Prostate cancer is one of the most common malignant tumors of the male genitourinary system, and its incidence ranks first among male malignant tumors in the United States. In recent years, with the development and progress of China’s society, the aging of the population, the increasingly obvious westernization of dietary structure, and with the improvement and promotion of tumor detection technology, the incidence of prostate cancer is increasing year by year in China, and now it has become one of the common diseases that seriously affect the healthy life of elderly men in China.  Radical prostate cancer resection as a common treatment is widely carried out in clinical practice. However, while radical prostate cancer resection can effectively control the tumor, its postoperative concomitant urinary incontinence often brings much inconvenience to the patients’ life and greatly affects their quality of life. A large number of studies at home and abroad have shown that the incidence of urinary incontinence after radical prostate cancer surgery is about 48% to 55%, and 5% to 10% of patients still have varying degrees of urinary incontinence one year after surgery. How to further improve the postoperative incontinence while effectively treating the tumor, thus improving the quality of life of patients, is the direction that urologists are trying to explore.  Biofeedback combined with pelvic floor muscle training is currently an internationally recognized first-line treatment for postoperative urinary incontinence in prostate cancer. The pelvic floor muscles are a collective term for a group of muscles that hold the bladder, urethra, rectum and other important organs like a “hanging net” and perform important physiological functions. The study found that a series of pelvic floor exercises such as anal lift can effectively improve the occurrence of urinary incontinence after prostate cancer surgery. So what is “biofeedback”? Simply put, the biofeedback device can monitor the activity status of the pelvic floor muscles with the help of an electronic probe placed in the rectum, and convert the information into sound or visual signals to feedback to the doctor and patient, so that they can understand the pelvic floor muscle exercise situation, so as to develop a more appropriate exercise plan, which is a more scientific means to adjust the exercise and measure the response of the pelvic floor muscle exercise. For example, if a simple pelvic floor exercise is running fitness, biofeedback is equivalent to a fitness coach and a treadmill, which can assist us to complete the pelvic floor muscle exercise more efficiently and correctly.  So when exactly is biofeedback combined with pelvic floor exercises the best treatment? Previous treatment protocols have often recommended that patients begin treatment after radical prostate cancer surgery. However, in recent years, a growing number of studies have confirmed that this treatment can be more effective when started before radical prostate cancer surgery. In a large European randomized controlled study, patients who underwent biofeedback combined with pelvic floor muscle training three months after radical prostate cancer surgery had a significantly higher incontinence recovery rate than those who started treatment after surgery, with a 59.3 percent incontinence recovery rate three months after surgery compared to 37.3 percent after surgery.