Hfitness Study 2: Impact in Men following Prostate Removal
Conclusions: HFITNESS produces significant improvements to incontinence and quality of life measures in men undergoing prostatectomy. These benefits are long-term, with improvements seen through 1 year post-operatively.
Background: Although pelvic floor muscle training (PFMT) is widely shown to improve post- prostatectomy incontinence (PPI), numerous barriers impede access to formal PFMT and include the limited availability of specialized therapists and financial or scheduling barriers. To address these barriers, we developed a novel online program (HFITNESS) delivering comprehensive long-term PFMT, pelvic floor education (PFE), and dietary/behavioral modification education.
Methods: Patients anticipating robotic-assisted laparoscopic prostatectomy (RALP) underwent HFITNESS rebabilitation. HFITNESS is a 12-month program of 3 phases, including multiple exercises with varied contraction types and duration, and comprehensive dietary and behavioral technique education. Incontinence and quality of life were are assessed at 3 weeks, 3, 6, and 12 months following RALP using validated International Consultation on Incontinence Questionnaire Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) and Incontinence Impact Questionnaire (IIQ-7) questionnaires and additional items assessing satisfaction, improvement, and daily pad use.
Results: Analysis included 21 men (64±6 years). At 6-month follow-up, men undergoing HFITNESS showed significant improvement in incontinence degree and quality of life as compared to the 3-week time point. Six-month patient-reported improvement averaged 7.42±0.74 (10-point Likert scale). All (100%) respondents reported the program easy to use, educational, and would recommend it to others, with 89% expressing satisfaction with the program. During patient interview at 6-month follow-up, no men reported inability to access the program online or any adverse events.