{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T19:52:10Z","timestamp":1785873130602,"version":"3.56.0"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T00:00:00Z","timestamp":1698624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Urinary incontinence (UI) can negatively impact quality of life (QoL) after robot\u2010assisted radical prostatectomy (RARP). Pelvic floor muscle training (PFMT) and duloxetine are used to manage post\u2010RARP UI, but their efficacy remains uncertain. We aimed to investigate the efficacy of PFMT and duloxetine in promoting urinary continence recovery (UCR) after RARP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A randomized controlled trial involving patients with urine leakage after RARP from May 2015 to February 2018. Patients were randomized into 1 of 4 arms: (1) PFMT\u2010biofeedback, (2) duloxetine, (3) combined PFMT\u2010biofeedback and duloxetine, (4) control arm. PFMT consisted of pelvic muscle exercises conducted with electromyographic feedback weekly, for 3 months. Oral duloxetine was administered at bedtime for 3 months. The primary outcome was prevalence of continence at 6 months, defined as using \u22641 security pad. Urinary symptoms and QoL were assessed by using a visual analogue scale, and validated questionnaires.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From the 240 patients included in the trial, 89% of patients completed 1 year of follow\u2010up. Treatment compliance was observed in 88% (92\/105) of patients receiving duloxetine, and in 97% (104\/107) of patients scheduled to PFMT\u2010biofeedback sessions. In the control group 96% of patients had achieved continence at 6 months, compared with 90% (<jats:italic>p<\/jats:italic>\u2009=\u20090.3) in the PMFT\u2010biofeedback, 73% (<jats:italic>p<\/jats:italic>\u2009=\u20090.008) in the duloxetine, and 69% (<jats:italic>p<\/jats:italic>\u2009=\u20090.003) in the combined treatment arm. At 6 months, QoL was classified as uncomfortable or worse in 17% of patients in the control group, compared with 44% (<jats:italic>p<\/jats:italic>\u2009=\u20090.01), 45% (<jats:italic>p<\/jats:italic>\u2009=\u20090.008), and 34% (<jats:italic>p<\/jats:italic>\u2009=\u20090.07), respectively. Complete preservation of neurovascular bundles (NVB) (OR: 2.95; <jats:italic>p<\/jats:italic>\u2009=\u20090.048) was the only perioperative intervention found to improve early UCR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PFMT\u2010biofeedback and duloxetine demonstrated limited impact in improving UCR after RP. Diligent NVB preservation, along with preoperative patient and disease characteristics, are the primary determinants for early UCR.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pros.24634","type":"journal-article","created":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T05:14:45Z","timestamp":1698729285000},"page":"158-165","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Assessing the efficacy of pelvic floor muscle training and duloxetine on urinary continence recovery following radical prostatectomy: A randomized clinical trial"],"prefix":"10.1002","volume":"84","author":[{"given":"Rafael","family":"Sanchez\u2010Salas","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Urology McGill University Montreal Canada"},{"name":"Department of Urology Institut Mutualiste Montsouris, Universit\u00e9 Paris\u2010Descartes Paris 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do ABC (ABC Medical School) S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Candela","sequence":"additional","affiliation":[{"name":"Department of Urology Institut Mutualiste Montsouris, Universit\u00e9 Paris\u2010Descartes Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Cathala","sequence":"additional","affiliation":[{"name":"Department of Urology Institut Mutualiste Montsouris, Universit\u00e9 Paris\u2010Descartes Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annick","family":"Mombet","sequence":"additional","affiliation":[{"name":"Department of Urology Institut Mutualiste Montsouris, Universit\u00e9 Paris\u2010Descartes Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Marra","sequence":"additional","affiliation":[{"name":"Department of Urology Institut Mutualiste Montsouris, Universit\u00e9 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