Issue 25-1, 2026

Original article

https://doi.org/10.38025/2078-1962-2026-25-1-53-64

Effectiveness of a Rehabilitation Program for Post-Prostatectomy Urinary Incontinence: A Randomized Controlled Study

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ORCIDViktor S. Kostenich*

S.I. Georgievsky Order of the Red Banner of Labor Medical Institute, Simferopol, Russia


ABSTRACT

INTRODUCTION.  Prostate cancer (PCa) is one of the most common cancers in men, with an annual increase in incidence, mainly due to early stages. Radical prostatectomy (RPE) is the main method of radical treatment for clinically significant PCa, but this method often leads to urinary incontinence (UI). There are many different methods of conservative treatment for this group of patients with UI in the postoperative period, but scattered data in the literature indicate that there is no single standard for the combination of methods for treating UI.

AIM.  To compare the effectiveness of the proposed medical rehabilitation program for patients with UI after RPE with standard management.

MATERIALS AND METHODS.  This prospective clinical study was conducted from September 2021 to May 2025 at St. Luke Multidisciplinary Clinical Hospital (V.I. Vernadsky Crimean Federal University) and the Department of Rehabilitation Treatment of Health and Rehabilitation Technologies Scientific and Clinical Centre (V.I. Vernadsky Crimean Federal University). The study included 142 patients after RPE, divided into two groups: modified treatment (n = 63) and control (n = 79). The median follow-up period was 366 days. Both groups underwent pelvic floor muscle training. The modified treatment group additionally used biofeedback, pelvic floor muscle electrostimulation, and Nordic walking as elements of a comprehensive rehabilitation programme.

RESULTS.  Preoperative parameters and 1-month postoperative outcomes did not show statistically significant differences between the groups. 3 months after surgery, UI was observed in 25 % of patients in the modified treatment group versus 52 % in the control group (p = 0.001), and urine loss volume was 35 % lower (9 mL vs 14 mL; p = 0.008). After 6 months, UI persisted in 16 % versus 39 % (p = 0.002), and urine loss volume was 37 % lower (4 mL vs 6 mL; p = 0.016). Pelvic floor muscle strength was higher in the modified treatment group in 3 and 6 months (119 and 131 cm of water vs 109 and 126 cm of water; p < 0.01). Quality of life scores measured by EORTC QLQ-C30/PR25 improved significantly in 3, 6, and 12 months (77, 80 and 80 points vs 69, 71 and 78 points; p < 0.05).

DISCUSSION.  The findings indicate that modified comprehensive rehabilitation ensures faster recovery of urinary continence in the early stages after RPE (3–6 months), which is manifested by a decrease in the frequency of UI, a reduced volume of urinary leakage, and a more pronounced increase in pelvic floor muscle strength. The parallel improvement in quality of life indicators confirms the clinical significance of the effect and its translation into patient-centred outcomes.

CONCLUSION.  The modified medical rehabilitation program promotes faster restoration of urinary continence after RP compared with standard treatment. The greatest benefit was observed in the mid-term follow-up, potentially reducing the period of social maladaptation and decreasing the burden on the healthcare system.


KEYWORDS: urinary incontinence, radical prostatectomy, men’s rehabilitation, rehabilitative treatment, medical rehabilitation, pelvic floor muscle training, electrical stimulation, Nordic walking

FOR CITATION: Kostenich V.S. Effectiveness of a Rehabilitation Program for Post-Prostatectomy Urinary Incontinence: A Randomized Controlled Study. Bulletin of Rehabilitation Medicine. 2026; 25(1):53–64. https://doi.org/10.38025/2078-1962-2026-25-1-53-64 (In Russ.).

FOR CORRESPONDENCE:

Viktor S. Kostenich, E-mail: v-kostenich@mail.ru, vskostenich@cfuv.ru


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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.