Prostate cancer accounts for approximately 30% of all cancers diagnosed in men per year. Robotic Prostatectomy is a increasingly common surgery performed at Peter MacCallum Cancer Centre. Post operatively, numerous side effects have been well documented throughout the literature, including incontinence. Pelvic floor exercises are a common treatment option for patients to assist with loss of continence. The physiotherapy department at Peter MacCallum have not been involved with the education nor care of Robotic Prostatectomy patients.
A literature review was commenced to investigate the relationship between pelvic floor muscle training and incontinence post prostatectomy. Current evidence does not suggest that pelvic floor exercises prior to prostatectomy improves incontinence, however, studies do show that pelvic floor muscle training is effective in reducing incontinence post prostatectomy. This information was presented to the physiotherapy department. The Robotic Prostatectomy Nurse Co-ordinator was contacted to gain insight into level of education patients currently receive on post operative side effects, and specifically incontinence. Prior to surgery, patients attend a clinic with the Nurse Co-ordinator who provides information on expectations of incontinence, and suggests techniques for pelvic floor exercises. The Nurse Co-ordinator was supportive of physiotherapy involvement in the clinic. to assist with education of incontinence.
Early in 2014, Peter MacCallum Physiotherapy commenced presentations at the Robotic Prostatectomy Clinic, with the aim to increase education, awareness and emphasise the importance of seeing a continence physiotherapist. Patients are educated on how the urinary system works, how this is impacted by surgery, the role of the pelvic floor and importance of pelvic floor exercises to maintain continence. Patients are provided with locations of continence clinics both within the metropolitan and rural areas, as well as provision of question time with the physiotherapist to ensure consolidation of knowledge.