Is a behavioral treatment for urinary incontinence beneficial to prostate cancer survivors as a follow-up care?

Abstract

Purpose: The American Cancer Society (ACS) recommends a follow-up care plan for urinary incontinence of prostate cancer survivors that includes pelvic floor muscle exercise (PFME). We examined potential impacts and access barriers of this recommendation with consideration of patients who normally do not seek such care.

Methods: We compared 267 participants of a clinical trial that tested a PFME-based treatment of urinary incontinence and 69 nonparticipants who declined the trial. All subjects were assessed at baseline, 3, and 6 months on leakage frequency, disease-specific quality of life (QOL), and physical well-being. The nonparticipants were interviewed to examine reasons for intervention refusal.

Results: The participating and nonparticipating groups did not differ in most baseline demographics and clinical variables except that the nonparticipants had lower baseline prostate-specific antigen (P ≤ 0.01), lower education levels, and higher likelihood of receiving surgery alone (both P ≤ 0.05). Nonparticipants exhibited significantly more frequent daily leakage, poorer urinary function and bother, and severer urinary problems at 3 and 6 months, as well as worse physical well-being at 6 months, relative to baseline, than the participants. The primary reason for refusal was economical, such as lacking transportation and time for participation.

Conclusions: Urinary function and QOL can worsen without appropriate follow-up care. It is important to make a PFME-based follow-up care program available to all incontinent prostate cancer survivors as recommended by ACS guidelines.

Implications for cancer survivors: Seeking PFME-based treatment is crucial for long-term urinary health outcomes even if present leakage is minor or financial challenge is a concern.

Keywords: Pelvic floor muscle exercise; Prostate cancer; Quality of life; Survivorship; Urinary incontinence.

Conflict of interest statement

Conflict of interest The authors declare that they have no conflicts of interest.

Figures

Fig. 1

Urinary incontinence and quality of life outcomes by time and group