Impact of Structured Pre- and Postoperative Pelvic Floor Muscle Training On Early Continence Recovery Following Open Radical Prostatectomy: A Retrospective Cohort Study in a Resource-Limited Setting

Abstract

Abstract Background: Urinary incontinence remains a significant functional complication following open radical prostatectomy (ORP), impacting patients’ quality of life. Pelvic floor muscle training (PFMT) has been proposed as an effective intervention to accelerate continence recovery, but its role, especially when initiated preoperatively in resource-limited settings, remains underexplored. Objective: This study aimed to evaluate the impact of structured pre- and postoperative PFMT on early urinary continence recovery following ORP. Materials and Methods: We conducted a retrospective cohort study at Baptist Hospital Nkwen and Regional Hospital Bamenda from March 2021 to December 2023. Male patients aged 40–75 years undergoing ORP for localised prostate cancer were included in the study. Participants were divided into a PFMT group ( n = 15) and a control group ( n = 11). Continence outcomes were assessed at 1, 3, and 6 months post-catheter removal. Data were analysed using Chi-square tests, Kaplan-Meier survival analysis, and Cox proportional hazards regression and log-rank test. Results: At 1 month, 60.0% of PFMT participants achieved continence compared to 18.2% of controls ( P = 0.041). At 2 months, continence rates were 86.7% versus 45.5% ( P = 0.027), and at 6 months, 100% versus 72.7% ( P = 0.049), respectively. Median time to continence recovery was 6 weeks in the PFMT group versus 14 weeks in the control group ( P = 0.002). Participation in PFMT independently predicted earlier continence recovery (hazard ratio: 2.86, 95% confidence interval: 1.15–7.10, P = 0.023). Conclusion: Structured pre- and postoperative PFMT significantly improves early urinary continence recovery following ORP. Integrating PFMT into perioperative care pathways should be encouraged, especially in resource-constrained environments.