Effect of pelvic floor muscle training plus acupuncture versus pelvic floor muscle training alone on incontinence-related quality of life after radical prostatectomy: A randomized clinical trial

PURPOSE: The purpose of this study was to evaluate the effect of acupuncture combined with pelvic floor muscle training vs. pelvic floor muscle training alone on quality of life related to urinary incontinence in men after radical prostatectomy. DESIGN: Randomized clinical trial. SUBJECTS AND SETTING: Men who underwent radical prostatectomy in a central major public hospital in Brazil within the prior 2 months and self-reported urinary loss requiring daily use of a pad, diaper, or liner. MATERIAL AND METHODS: Sixty-eight individuals were randomized into 2 groups: control (pelvic floor muscle training) and intervention (acupuncture plus pelvic floor muscle training). Both groups had 8 intervention sessions, delivered once weekly. The data were analyzed at baseline (T0), 5 weeks (T1), and 9 weeks (T2) after the start of treatment. The International Consultation on Incontinence Questionnaire-Short Form and the King's Health Questionnaire were used to assess the quality of life related to urinary symptoms from the physical, social, and emotional aspects. Longitudinal changes were analyzed using Generalized Estimating Equations, including group, time, and group × time interaction effects. RESULTS: Compared with baseline, the intervention group showed significantly greater reductions in International Consultation on Incontinence Questionnaire-Short Form scores at T1 (β = −5.53; 95% CI −7.49 to −3.58) and T2 (β = −7.21; 95% CI −9.49 to −4.92) than the control group. For the King's Health Questionnaire, significant main effects of time were observed for all domains, indicating overall improvement in quality of life in both groups. Significant group × time interaction effects were identified for most domains, with greater improvements in the intervention group, particularly for the impact of urinary incontinence, physical limitations, emotions, and severity measures. No significant interaction effects were observed for perceived health or personal relationships. CONCLUSIONS: Acupuncture associated with pelvic floor muscle training was effective in improving quality of life related to urinary incontinence in following radical prostatectomy.
This work has been funded by the Minas Gerais State Research Foundation (FAPEMIG) (grant number: APQ—01034-21), through the National Council for Scientific and Technological Development (Process No 311425/2020-7 and Process No 429958/2018-8) and by the Department for the Improvement of Higher Education Personnel—Brazil (CAPES)—Funding code: 001.