Generación de Nuevo Conocimiento: Artículos publicados en revistas especializadas - Electrónicos
El entrenamiento preoperatorio induce cambios en la histomorfometría y función de los músculos del suelo pélvico en pacientes con indicación de prostatectomía radical
Fecha
2014-08Autor
Ocampo-Trujillo, Á.
Carbonell-González, J.
Martínez-Blanco, A.
Díaz-Hung, A.
Munoz, C.A.
Ramírez-Vélez, R.
Institución
Resumen
Objective: To evaluate the efficacy of preoperative pelvic floor muscle training (PFMT) on histomorphometry, muscle function, urinary continence and quality of life of patients undergoing
radical prostatectomy (RP).
Material and methods: A prospective intervention clinical study was designed in 16 patients
with indication of RP who were randomized into two groups. The Control Group received routine
pre-surgical education (hygienic-dietary measures). The intervention group received a training
session with supervised PFMT, three times a day, for four weeks, 30 days before the PR. Muscle
function of the external urethral sphincter, contraction pressure of the levator ani, urinary
continence and quality of life related to health (HRQoL) were evaluated before and after the
intervention. At the end of the intervention and day of the surgery, samples of residual muscle
tissue were obtained from the external sphincter muscle of the urethra for histomorphometric
analysis.
Results: After the intervention, those participants who carried out PFMT showed an
increase in the cross-sectional area of the muscle fibers of the external urethral sphincter
(1,313 ± 1,075 m2 vs. 1,056 ±844 m2, P = .03) and higher pressure contraction of the levator
ani (F = 9.188; P = .010). After catheter removal, 62% of patients in the experimental group and
37% in the control group showed no incontinence. After removal of the catheter, 75% of the
experimental group did not require any pad compared to 25% in the control group (p=NS). There
were no significant differences between the two groups in any of the HRQoL domains studied.
Conclusions: Pre-surgical PFMT in patients with RP indication induces changes in the histology
and function of the pelvic floor muscles, without changes in urogenital function and HRQoL.
These results provide new evidence regarding the benefit of PFMT in preventing RP associated
complications.