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One-to-one physical therapy is neither effective nor cost effective after prostate surgery

Friday, July 8, 2011 (Last Updated: 07/11/2011)

FRIDAY, July 8 (HealthDay News) -- One-to-one conservative physical therapy does not improve urinary incontinence in men compared to standard care after prostate surgery, according to a study published online July 8 in The Lancet.

Cathryn Glazener, Ph.D., from the University of Aberdeen in the United Kingdom, and colleagues assessed whether formal one-to-one pelvic-floor muscle training reduces incontinence in men. Participants who had urinary incontinence six weeks after surgery for radical prostatectomy (trial one) or transurethral resection of the prostate (trial two) were randomly allocated to receive four sessions with a therapist over three months, or standard care and lifestyle advice. Participants' reports of urinary incontinence and incremental cost per quality-adjusted life-year (QALY) after 12 months were considered primary end points.

The investigators found that there was no significant difference in the rate of urinary incontinence at 12 months in the intervention or control groups in either trial one or trial two. Neither group experienced adverse effects. In both the trials there were higher mean costs per patient in the intervention group compared with the control group, but there was no economically important difference in QALYs.

"In settings where information about pelvic-floor exercise is widely available, one-to-one conservative physical therapy for men who are incontinent after prostate surgery is unlikely to be effective or cost effective," the authors write.

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Specialties Hematology & Oncology
Internal Medicine

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