Fisioterapia en la incontinencia urinaria severa y disfunción eréctil posprostatectomíaestudio de un caso

Resumo

Background and objective Radical prostatectomy has become the reference method for treating prostate cancer. New surgical techniques have been developed to try to maximize results in tumour resection and minimize sequelae, resulting in radical robotic prostatectomy. Although there appear to be better outcomes, there are still a significant percentage of patients with sequelae, such as urinary incontinence and erectile dysfunction. It has been shown that physiotherapy can contribute to the resolution of these sequelae by shortening healing times in open and laparoscopic prostatectomy. The aim of this study is to determine the effects of physiotherapy treatment on the sequelae of radical robotic prostatectomy. Case report A 63-year-old patient underwent robotic radical prostatectomy for prostate adenocarcinoma, Gleason 6 (3 + 3), bilateral. At the beginning of the treatment, the patient had very severe incontinence, with a loss of 332 g in the 1-h pad test, and a severe dysfunction with a score of 5 in the International Index of Erectile Function questionnaire (IIEF-15). Intervention Application of a physiotherapy program consisting of awareness, barometric biofeedback, and intracavitary electrostimulation of the pelvic floor musculature, performed 3 days/week, 1 h for 32 weeks. Results and discussion The patient achieved erectile function at 6 months, with a score of 26 in the IIEF-15, and continence at 8 months, with 0 g of loss in the 1-h pad test.