A Randomized Controlled Trial Comparing the Effects of Pelvic Floor Muscle Training Alone and Biofeedback Combined with Pelvic Floor Muscle Training on Urinary Incontinence after Laparoscopic Radical Prostatectomy
Punyapat Teerarungsikul, MD¹, Supachai Sathidmangkang, MD¹
Affiliation : ¹ Department of Urology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Objective: To improve urinary continence recovery after laparoscopic radical prostatectomy, this randomized controlled trial (RCT) evaluated the effectiveness of combining biofeedback (BF) with pelvic floor muscle training (PFMT). Urinary incontinence significantly impacts patients’ quality of life, and BF may enhance PFMT, making rehabilitation more effective than PFMT alone.
Materials and Methods: The present study included prostate cancer patients at Vajira Hospital between March 2022 and December 2024. Participants were randomized into two groups: group A (PFMT alone) and group B (BF+PFMT) completing a 12-week program. Urinary continence was assessed using the 1-hour pad test and ICIQ-UI Short Form scores at baseline, 4, 8, and 12 weeks post-catheter removal. Statistical analyses included t-tests, Mann-Whitney U tests, chi-square tests, and odds ratios.
Results: Sixty-eight patients, with 34 per group, were analyzed. Both groups had similar baseline characteristics. No significant differences were found in continence outcomes at later time points, but group B showed significantly greater improvement in the 1-hour pad test within the first four weeks (p=0.009). Patients in group B were 3.04 times more likely to experience early improvement (p=0.027).
Conclusion: PFMT and BF+PFMT improve urinary continence, with BF offering short-term benefits but no long-term advantage. PFMT remains a reliable intervention, while BF may aid early recovery. Patients should be counseled on potential early continence decline to set expectations and encourage adherence, supporting BF use in the early postoperative period, at four weeks. The study was limited by limited sample size, follow-up, and adherence, thus, a larger RCT is needed.
Received 29 September 2025 | Revised 9 December 2025 | Accepted 17 December 2025
DOI: 10.35755/jmedassocthai.2026.2.03333
Keywords : Urinary incontinence; Pelvic floor muscle training; Biofeedback therapy; Laparoscopic radical prostatectomy; Post-prostatectomy incontinence; Urinary leakage recovery
