BACKGROUND Transient postoperative urinary incontinence is a bothersome complication of holmium laser enucleation of the prostate (HoLEP). The effects of preoperative pelvic floor muscle exercise (PFME) for early recovery of continence after HoLEP have never been elucidated. The aim of this study was to determine the benefit of preoperatively started PFME for early recovery of continence after HoLEP. METHODS We randomly assigned patients to start PFME preoperatively and continue postoperatively (group A) or start PFME no earlier than the postoperative period (group B). The primary outcome was time to complete urinary control, defined as no pad usage. The secondary outcome was measured using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score. Univariate and multivariate analyses were performed to identify parameters associated with recovery of continence after HoLEP. RESULTS Seventy patients were randomized across groups A (n = 35) and B (n = 35). Patients' characteristics were not different between groups A and B. The postoperative urinary incontinence rate significantly decreased in group A compared with that in group B at 3 months postoperatively [3% vs. 26% (P = 0.01)]. However, there were no significant differences between groups A and B at 3 days [40% vs. 54% (P = 0.34)], 1 month [37% vs. 51% (P = 0.34)], and 6 months [0% vs. 3% (P = 1.00)] postoperatively, respectively. The postoperative ICIQ-SF score was not significantly different between groups A and B at any time point postoperatively. In univariate analysis, patients who performed preoperative PFME had a 0.56-fold lower risk of urinary incontinence 1 month after HoLEP and a 0.08-fold lower risk of urinary incontinence 3 months after HoLEP. CONCLUSIONS Preoperatively started PFME appears to facilitate improvement of early urinary continence after HoLEP. TRIAL REGISTRATION The study was registered with the University Hospital Medical Information Network Clinical Trials Registry in Japan (UMIN000034713); registration date: 31 October 2018. Retrospectively registered.

中文翻译：

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术前盆底肌运动对前列腺激光摘除术后早期节制的影响：一项随机对照研究。

背景技术术后短暂性尿失禁是前列腺激光摘除术（HoLEP）的令人讨厌的并发症。从未阐明术前骨盆底肌肉锻炼（PFME）对HoLEP术后尿失禁的早期恢复的影响。这项研究的目的是确定术前开始PFME对HoLEP术后大便失禁早期恢复的益处。方法我们随机分配患者术前开始PFME并继续术后（A组）或不早于术后时期开始PFME（B组）。主要结果是完成尿液控制的时间，定义为不使用尿垫。次要结果是使用国际失禁问卷调查表（ICIQ-SF）评分来衡量的。进行单因素和多因素分析以鉴定与HoLEP术后大便恢复相关的参数。结果70例患者被随机分为A组（n = 35）和B组（n = 35）。A组和B组的患者特征无差异。术后3个月，A组的术后尿失禁率明显低于B组[3％vs. 26％（P = 0.01）]。但是，A组和B组在第3天[40％对54％（P = 0.34）]，1个月[37％对51％（P = 0.34）]和6个月[0]之间没有显着差异。 ％相对于3％（P = 1.00）]。术后任何时间，A组和B组的术后ICIQ-SF评分均无显着差异。在单因素分析中，进行术前PFME的患者为0。HoLEP术后1个月尿失禁的风险降低了56倍，HoLEP术后3个月尿失禁的风险降低了0.08倍。结论术前开始PFME似乎有助于改善HoLEP术后早期尿失禁。试验注册本研究已在日本大学医院医学信息网络临床试验注册中心（UMIN000034713）进行了注册；注册日期：2018年10月31日。进行追溯注册。