Urinary incontinence
Conditions
Interventions
Intervention for the EMAP group (active control) - Number of participants: 23
The MAP exercises: performing diaphragmatic inspiration along with the relaxation of the MAPs and, upon slow expiration, c
Other
E05.723.402
Sponsors
Hospital Federal dos Servidores do Estado do Rio de Janeiro
Universidade do Estado do Rio de Janeiro - UERJ
Eligibility
Sex/Gender
Male
Age
50 Years to 75 Years
Inclusion criteria
Inclusion criteria: Patients with urinary incontinence after retropubic radical prostatectomy surgery; minimum time of one month and maximum of up to six months post surgery;cancer staging at low and intermediate risks
Exclusion criteria
Exclusion criteria: Symptoms of urinary tract infection; symptoms of lower urinary tract obstruction; anal fistula; metal implant in the body; transurethral resection of the prostate; previous radiotherapy; neurological diseases; non-execution of the proposed treatment
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Urinary incontinence The patients will be submitted to an anamnesis about the urinary symptoms, quantities of disposable protectors used per day, urine losses to the efforts, associated pathologies. The patient will be asked about the number of disposable protectors he uses per day, asking the patient to pay attention to the disposable protectors used the next day to confirm this information at the next care. The criterion of success to achieve urinary continence, in addition to the 1 hour pad test with a value less than 1 g15, will be the use of no daily disposable protector. The pad test, which aims to evaluate urinary continence, measures the weight of a disposable protector. The patient will put on a pre-weighed protector and will ingestion of 500 ml of water, remaining seated for 15 minutes. The patient will be asked to perform certain actions simulating activities of daily living, such as climbing and descending a ladder for 15 minutes, sitting and lifting ten times, coughing ten times, picking up objects on the floor five times, running in the same place for one minute and washing hands in running water for one minute15. After carrying out the proposed activities, the absorbent will be removed and weighed on a precision balance of the Mettler Toledo brand model Bd 202 with an accuracy of 0.01 g and a maximum capacity of 200 g. Urinary losses will be assessed and classified: losses of up to 1 g are considered insignificant; between 1.1 and 9.9 g, are classified as light losses; between 10 and 49.9 g, are moderate losses; and above 50 g, severe losses. The urine loss will be calculated by the weight of the post-pad protector test 1h less weight of the protector pad 1h test. Outcome measured before the intervention and after 20 treatment sessions or immediately upon discharge from the patient. Urinary continence is expected | — |
Secondary
| Measure | Time frame |
|---|---|
| Strength of pelvic floor muscles The strength of the MAPs will be measured by a peritron perineometer (PFX 9300®, Cardio-Design Pty. Ltd, Baulkham Hills, Australia, 2153), which presented a typical measurement error of 3.1 cmH2O (4%) and CCI of 0.99 (95% CI = 0.98 to 0.99). The patients will be familiarized with three contractions and after two or four days the strength of the MAPs will be measured. The patient will lie in lateral decubitus with knees and hip flexed, naked from the waist down. The physiotherapist will introduce into the anal canal, with one hand the perineometer, and the other hand will be positioned over the abdomen to control the concomitant contraction of this muscle with the MAPs. The anal pressure will then be measured with a seamless medical grade silicone elastomer sensor. The sensor is connected to a portable microprocessor with a latex tube, allowing the measurement of the contraction pressure exerted by the MAPs in centimeters of water (cmH2O), thus quantifying the indirect force of the MAPs. Occlusive pressure readings from a pressure gauge are a proxy measure of force. The instrument will be calibrated to zero before each measurement. The anal sensor will not be inflated. According to the manufacturer, inflation is an optional feature that can reduce the sensitivity of the sensor response. Patients will be instructed to perform three maximal muscle contractions of the pelvic floor with an interval of 30 seconds between them, as reported in a study by Barbosa et al. Co-contractions of the buttocks and adductors of the hip will be discouraged, as will the Valsalva maneuver. The maximum value of the three contractions will be recorded. Outcome measured before the intervention and after 20 treatment sessions or immediately upon discharge from the patient.The strength of MAPs is expected to increase ; Impact of urinary incontinence on daily life Patients will undergo an evaluation of the impact of UI on daily life and the qualificatio | — |
Countries
Brazil
Contacts
Public ContactPatrícia ;Patrícia Zaidan;Zaidan
Universidade do Estado do Rio de Janeiro - UERJ;Universidade do Estado do Rio de Janeiro - UERJ
Outcome results
None listed