Extracorporeal magnetic innervation increases functional bladder capacity and quality of life in patients with urinary incontinence after robotic-assisted radical prostatectomy

摘要

Postprostatectomy incontinence (PPI) is a major health problem that has substantial effects on health-related quality of life. In recent years, extracorporeal magnetic innervation (ExMI) has become a preferred treatment method for urinary incontinence. We evaluated the effects of ExMI on patients with PPI after robotic-assisted radical prostatectomy (RARP), specifically regarding health-related quality of life. From September to December 2014, patients with post-RARP PPI were enrolled in the study. A 20-minute ExMI treatment session was provided twice a week for two months. Number of voids, incontinence and urgency episodes, and mean and maximum voided volume per micturition (mL) were recorded in a 3-day bladder diary. Quality of life was assessed using the Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), and International Prostate Symptom Score quality-of-life questionnaire (IPSS-QoL). All assessments were conducted before and within 2 weeks after ExMI treatment. A favorable outcome was defined as an IPSS-QoL score <2 or a >2-point decrease in the pretreatment score. Thirteen patients with a mean age of 69.3 years were enrolled. After ExMI, the number of incontinence episodes/3 d decreased to 5.85 from 9.15 (p = 0.004). The mean number of voids/d also decreased to 9.17 from 10.45 (p = 0.036). Patients' functional bladder capacity increased from 243.46 to 289.23 (p = 0.007). Scores of both UDI-6 and IPSS-QoL improved from 7.15 to 5.31 (p = 0.024) and 4.00 to 2.77 (p = 0.007). Patients aged <70 years were more likely to have a favorable outcome [odds ratio (OR) 28.6, confidence interval (CI) 1.12–731.40]. ExMI decreases the number of incontinence episodes, increases functional bladder capacity and quality of life in patients with post-RARP PPI, and may be considered as an option for patients with PPI.