Comparison of the effectiveness of different conservative treatment protocols in individuals with urinary incontinence symptom after prostatectomy

The aim of this study was to reveal the additional effects of Knack maneuver and lifestyle recommendations training on pelvic floor muscle training (PFMT) in a randomized controlled design in individuals with urinary incontinence (UI) complaints after radical prostatectomy. 66 individuals with UI complaints after prostatectomy were included in the study. Individuals were randomly assigned to Group 1 (PFMT with Knack maneuver and lifestyle recommendations), Group 2 (PFMT with Knack maneuver), or Group 3 (PFMT alone). During the 8-week study period, individuals were evaluated at baseline, at the end of the 4th week, and at the end of the 8th week. The primary outcome measure, subjective UI severity, and the effect of UI on the overall quality of life (QoL) were assessed using the International Consultation on Incontinence Questionnaire-Short Form. As secondary outcome measures, objective incontinence severity was assessed with the 1-hour pad test, the effect of incontinence on sub-domains of QoL with the King's Health Questionnaire, the perception of symptom severity of individuals with the Patient Global Impression of Severity scale, and the perception of recovery with the Patient Global Impression of Improvement. At the end of the study, it was determined that all outcome measures, except for the "general health perception", "personal relationships" and "severity measures" sub-domains of QoL, showed statistically significant changes in all groups over time (p<0,001). When within-group changes were compared between groups, adding the Knack maneuver and lifestyle recommendations to the PFMT revealed higher improvements for all outcome measures (p<0.001). In addition, adding only Knack maneuver training to PFMT without lifestyle recommendations showed superiority in terms of various outcome measurement parameters (subjective UI severity and general QoL, UI effect, perception of UI severity) compared to PFMT alone. As a result of this study, it was determined that in the treatment of UI after prostatectomy, better results were obtained in the short term with the addition of Knack maneuver and lifestyle recommendations to PFMT. There is a need for further follow-up studies that demonstrate the effects by maintaining long-term compliance with conservative approaches in the management of UI after prostatectomy.