Skip to main content
Download PDF

Effect of Pilates combined with pelvic floor muscle training on continence of post-prostatectomy incontinence in patients with different body mass index

BMC Urology volume 24, Article number: 74 (2024) Cite this article

Abstract

Background

Urinary incontinence symptoms severely affect older people with different body mass index (BMI).To compare the efficacy of the pelvic floor muscle training (PFMT) in patients with post-prostatectomy incontinence with different BMI.

Methods

Thirty-seven patients with post-prostatectomy incontinence were included. They were divided into group A (BMI ≤ 25,12), group B (26 ≤ BMI ≤ 30,14), and group C (BMI ≥ 31,11) based on difference BMI. Three groups of patients underwent the same Pilates combined with kegel training. Participants were assessed with 1-hour pad test, the number of incontinence episodes, International Consultation on Incontinence Questionnaire and Oxford Grading Scale.

Results

In the 1-hour pad test, the differences before and after training were statistically significant in all three groups of participants. Group A decreased from 81.83 ± 8.79 to 31.08 ± 5.64 g (P < 0.01). Group B decreased from 80.57 ± 8.87 to 35.85 ± 5.66 g (P < 0.01). Group C decreased from 83.55 ± 10.24 to 40.18 ± 7.01 g (P < 0.01). The number of incontinent episodes in group A decreased from 9.33 ± 1.07 to 3.25 ± 0.62 (P < 0.01). Group B decreased from 8.86 ± 1.09 to 3.79 ± 0.80 (P < 0.01). Group C decreased from 9.27 ± 1.10 to 4.09 ± 0.70 (P < 0.01). The correlation between the three groups of participants and the 1-hour pad test, with an R2 of 0.51. The correlation between the three groups of participants and the number of urinary incontinence episodes with a R2 of 0.43.

Conclusions

Pelvic floor muscle training can affect the recovery of urinary continence in patients with different BMI. Maintaining a lower BMI can be beneficial for improving urinary control.

Trial registration

Date of trial registration: November 27, 2023.

Peer Review reports

Introduction

Post-prostatectomy incontinence(PPI) is an iatrogenic injury, which is difficult to avoid [1]. Its incidence typically ranges from 7 to 87%, decreasing to 5% to 20% after 1–2 years [2]. The incidence of this disease varies greatly, the main influencing factors are the amount of urine leakage during the first catheter removal, the definition of incontinence after radical prostatectomy, the selection of patients, and the surgical technique [3, 4]. To this day, the main pathophysiology of urinary incontinence is still not perfectly explained, mainly due to bladder neck dysfunction, intraoperative nerve injury and intrinsic sphincter insufficiency resulting in from sphincter relaxation [5]. The impact of urinary incontinence on society and men's daily life is enormous [6, 7], it causes a large amount of expenditure of health resources, affects the social interaction of men, and easily causes the social isolation of the elderly, it is an important indicator for the recruitment of nursing homes [8]. It increases the risk of falls [9], has an impact on the activities of daily living of partners [10], and increases mortality in home care [11].

Regarding the non-surgical treatment of urinary incontinence, it is emphasized in the guidelines of the European Urological Association and the 6th International Consultation on Urinary Incontinence that pelvic floor training should be included in the first-line treatment [12, 13]. However, Goode et al. suggest that traditional pelvic floor training is suboptimal because some patients are unwilling to undergo it [14]. In recent years, Pilates training has achieved good results in the treatment of patients with urinary incontinence after prostate surgery and can well arouse the enthusiasm of patients, it seems that Pilates training can be used in the conservative treatment of Post-prostatectomy incontinence [15, 16].

Obesity accounts for 300,000 deaths each year in the United States, and obese persons have increased all-cause mortality relative to normal-weight persons [17, 18]. Obesity also affects the urinary system. For every 5-unit increase in BMI, the risk of urinary incontinence increases by 60% to 80% [19]. In women, weight loss of more than 5% is associated with a 50% reduction in the frequency of urinary incontinence [20]. During the six months of weight loss, the incidence of all types of incontinence decreased and the number of incontinence episodes decreased, it seems that there is a benefit to the recovery of urinary incontinence with decreasing BMI [21]. However, the influence of different BMI groups on the effect of pelvic floor training in men is rarely reported. Therefore, the main objective of this paper was to determine the effects of Pilates combined with Kegel training on urinary control and pelvic floor muscle strength in patients with urinary incontinence after prostate surgery with different BMI. This is also the novelty of this paper, that is, through different BMI groups, to determine whether the effect of pelvic floor training is affected.

Methods

Trial design

This study was a prospective cohort controlled trial conducted at the China Rehabilitation Research Center. From January 2023 to June 2023, Registered patients experiencing PPI were recruited from both outpatient and ward settings. They were all patients who had been diagnosed with PPI, either as outpatients or in the hospital. The study was approved by the ethics committee (2023–041-01), and it was conducted independently and thoroughly. Additionally, all patients were informed of the treatment process, they all signed a consent form for rehabilitation.

Patients

Inclusion criteria: Participants aged 60 to 80 years and within 1 year of surgery. Retropubic radical prostatectomy and laparoscopic radical prostatectomy. The patient's condition was stable and the wound healed well after surgery. 1 h pad test greater than 2 g [22]. Exclusion criteria were participants who withdrew or had incomplete data, had a history of other urologic procedures, had a history of neurologic disease, or had psychiatric symptoms. Initially, we planned to enroll 60 participants, 20 in each trial group, G*power software was used to calculate the sample size,to account for an alpha of 0.05, 80% power, and a between-group effect size of 60% [23]. A total of 49 patients were selected to participate in the study. Considering the different BMI [BMI = Height(m)/weight (kg)2] of the participants could affect the urinary control treatment of pelvic floor exercise [23]. We divided the patients into three groups according to the BMI range of the participants, there were 17 participants each in groups A (BMI ≤ 25) and B(26 ≤ BMI ≤ 30), and 15 participants in group C(BMI ≥ 31).

Procedure

Through the model of group discussion, we developed a pelvic floor training program. Before the training, the pelvic floor anatomy and related knowledge were introduced to all patients, and the intake of caffeine-containing beverages was reduced. The treatment protocol was identical for all three groups of patients, who were all instructed in pelvic floor training by the same therapist. The training program was conducted by Pilates combined with pelvic floor muscle training. Pilates training we refer to studies developed by others [24, 25] (Table 1). The pelvic floor muscle training method was formulated according to other studies, each time the anus was contracted for 5 s, and the relaxation was 3 s. Our patients were encouraged to contract the anus as much as possible, with each contraction ensuring movement of the penis or scrotum. We let our patients experience which muscles force when flow is interrupted during voiding, and we do our best to strengthen the voluntary contraction of these muscles [26]. the PERFECT evaluation model was used for training assess [27]. All patients were required to train daily in the hospital, each training session lasted 45 min, and training lasted for 2 months. Urinary continence was evaluated every Saturday and Sunday, and data were recorded. Data was collected by nurses who were unaware of the study grouping and training methods.

Table 1 Pilates training program
Full size table

Evaluations

The primary outcome was the 1-h pad test. The patient was asked to wear the urine pad, Participants drank as much as 500 ml of water as possible and perform activities to stimulate urine leakage, such as going up and down stairs and walking, after 1 h, the urine pad was removed and weighed, and the urine leakage was judged by calculating the weight difference of the urine pad [28]. Data from 1-h pad tests were averaged over two consecutive days. According to the difference in pad weight, the patients were divided into: no incontinence < 2 g(no UI); mild urinary incontinence 2–9.9 g(mild UI); moderate UI 10–49.9 g(moderate UI) and severe UI > 50 g (severe UI) [28]. Secondary outcomes were number of incontinent episodes [26], The modified Oxford Grading Scale for recovery of pelvic floor muscle strength [29], and International Consultation Incontinence Questionnaire (ICIQ-SF) for subjective participant recovery [30]. The data were collected at the end of every week, and the changes of the evaluation indexes were recorded by the curve graph.

Statistics

SPSS 20 software was used for statistical analysis. The basic information of the patients was analyzed by one-way ANOVA test and Fisher's exact test. The 1-h pad test and the number of incontinence episodes were expressed as means and standard deviations, and the differences between groups were determined by one-way ANOVA, and the differences among the three groups and before, during and after treatment within the group were determined by 3 × 3 binary ANOVA. The Student–Newman–Keuls [S–N-K (S)] test was used for post hoc analysis of variance. The Oxford Rating Scale and the International Incontinence Consultation Questionnaire were expressed as medians and quartiles, and the Mann–Whitney rank sum test was used to determine differences between groups, and the signed rank sum test was used to determine differences before and after treatment. Spearman rank correlation was used to determine the correlation between different BMI groups and 1-h pad test, incontinence episodes, ICIQ-SF and Oxford Rating scale results after 8 weeks of treatment. P < 0.05 was considered statistically significant.

Results

There were no significant differences among the three groups in the basic demographic and clinical characteristics of the participants (Table 2). Of the planned 60 participants, 3 (5%) did not meet the inclusion criteria, 5 (8%) withdrew from the study, and 3 were excluded for other reasons. Subsequently, 49 participants (82%) entered the study. Finally, group A (12,20%), group B (14,23%) and group C (11,18%) completed the study (Fig. 1).

Table 2 The basic demographic and clinical characteristics of the 3 groups of samples
Full size table
Fig. 1
figure 1

Flow chart of the study

Full size image

Table 3 and Fig. 2(A-D) record the differences in the evaluation indicators before, during and after treatment among the three groups of participants. In the 1-h pad test, the differences before and after treatment were statistically significant in all three groups of participants. Group A decreased from 81.83 ± 8.79 to 31.08 ± 5.64 (P < 0.01). Group B decreased from 80.57 ± 8.87 to 35.85 ± 5.66 (P < 0.01). Group C decreased from 83.55 ± 10.24 to 40.18 ± 7.01 (P < 0.01). The number of urinary incontinent episodes in group A decreased from 9.33 ± 1.07 to 3.25 ± 0.62 (P < 0.01). Group B decreased from 8.86 ± 1.09 to 3.79 ± 0.80 (P < 0.01). Group C decreased from 9.27 ± 1.10 to 4.09 ± 0.70 (P < 0.01). On the ICIQ-SF scale, group A decreased from 18(18,19) to 7(6,8) (P < 0.01). Group B decreased from 18(18,19) to 8(7,8) (P < 0.01). Group C decreased from 18(18,19) to 8(8,9) (P < 0.01). Group A increased from 1(0,1) to 4(4,5) on the Oxford rating scale (P < 0.01). Group B increased from 1(0,1) to 4(3,4) (P < 0.01). Group C increased from 0(0,1) to 3(3,4) (P < 0.01). The curve showed that there were statistical differences among the three groups after the fifth week of treatment, and the differences before and after treatment increased. Pelvic floor muscle strength close to grade 4 is beneficial to the recovery of urinary control in patients with PPI.

Table 3 The 3 groups were statistically compared between and within groups
Full size table
Fig. 2
figure 2

Time curves and associated outcomes for the three groups of participants

Full size image

In the 1-h pad test, there was no significant difference among the three groups before treatment (P = 0.73), but there was a significant difference after treatment (P < 0.05). Post hoc test showed that only group A and group C had significant differences (P < 0.01). In the number of urinary incontinent episodes, there was no significant difference among the three groups before treatment (P = 0.48), but there was significant difference after treatment (P < 0.05). Post hoc test showed that only group A and group C had significant differences (P < 0.01). In ICIQ-SF scores, there was no significant difference among the three groups before treatment (P = 0.51), but there was significant difference after treatment (P < 0.05). Post hoc test showed that only group A and group C had significant differences (P < 0.01). In the Oxford rating scale, there was no significant difference among the three groups before treatment (P = 0.35), but there was significant difference after treatment (P < 0.05). Post hoc test showed that only group A and group C had significant differences (P < 0.01).

Figure 2 (E–H) shows the correlations with the four evaluation outcomes after 8 weeks of treatment for the three groups of participants. Panel E shows the correlation between the three groups of participants and the 1-h pad test, with an R2 of 0.51. Panel F shows the correlation between the three groups of participants and the number of urinary incontinence episodes, with a R2 of 0.43. Panel G shows the correlation between the three groups of participants and the ICIQ-SF, with a R2 of 0.48, and panel H shows the correlation between the three groups of participants and the Oxford rating scale, with a R2 of 0.45.

Discussion

Effects of different BMI on patients with PPI

Obese people have increased abdominal pressure, which will affect the pressure of abdominal organs, especially the change of bladder pressure. Subak et al. found a significant effect of weight change on urodynamic outcomes, Weight loss can reduce initial intravesical pressure and intravesical pressure at maximum capacity, improvement in Valsalva leak point pressure and change in bladder pressure after weight loss were independent predictors of improvement in urinary incontinence [23]. This confirmed our finding that there were differences among the 3 groups and that group A had a faster recovery in pelvic floor muscle strength and Incontinence episode frequency at week 4. There are differences in initial bladder pressure and detrusor instability due to abdominal pressure in patients with post-prostatectomy incontinence with different BMI [19, 23]. In addition, the risk of urinary incontinence is elevated following surgical resection of the prostate and surrounding tissues, particularly the urethral sphincter complex [31]. This results in obese patients with post-prostatectomy incontinence being more likely to develop incontinence symptoms. However, the aggravation of urinary incontinence symptoms will increase the risk of falls and aggravate the work of future nursing and family care [32]. In the trial, we found statistical differences between groups A and C only in the 1-h pad test. We speculate that controlling BMI in group B level by reasonable weight loss in patients with urinary incontinence with BMI > 31 can greatly improve the urinary control ability of patients with post-prostatectomy incontinence. We suggest that patients with post-prostatectomy incontinence should have a reasonable diet and weight control at the same time of pelvic floor training, which can reduce the difficulty of home care.

Advantages of pilates training combined with Kegel training

Some previous studies have confirmed that Pilates combined with Kegel training can effectively improve urinary control in patients with post-prostatectomy incontinence [24]. By transferring the traditional Kegel training for trunk stability to the Kegel training for trunk instability, the recruitment rate of trunk core muscles can be stimulated by different postural transitions [33], the study conducted by Stafford et al. revealed that the activation of core muscle groups can effectively enhance pelvic floor muscle contraction [34], abdominal muscle activity can improve pelvic floor muscle strength [35], so as to better promote the improvement of pelvic floor muscle strength [15, 16]. In trials, Pilates training mostly involved different positions. The shortcomings of traditional pelvic floor training can be further optimized by combining Kegel training with different postural changes. In addition, Dias et al. found that Pilates training can better promote the enthusiasm of patients for pelvic floor training compared with traditional pelvic floor training [36]. Therefore, we believe that Pilates combined with Kegel training is one of the best ways to perform pelvic floor training for patients with urinary incontinence.

Limitation

There was no blind treatment among the three groups, which may affect the training enthusiasm of different groups. However, we provided patient guidance to patients in each group during training to maximize the enthusiasm of patients, training methods were identical in all three groups to maximize the intention-to-treat analysis. Long-term follow-up is lacking in our study, we will continue to explore the long-term effects of pelvic floor exercise in patients with different BMI in future studies. Although none of the participants in the three groups had received professional pelvic floor training before entering the study, most of them obtained more or less relevant information about pelvic floor muscle training through doctor consultation, Internet and other ways. Therefore, our study is not fully representative of pelvic floor muscle training results in all populations with different BMI. The benefits of pelvic floor muscle training often diminish and disappear as patients discontinue the program, while simultaneously focusing too much on training intensity, which may potentially impact patient recovery in the long run. Therefore, future studies will aim to refine the training protocol.

Conclusion

Different BMI groups can affect the recovery of urinary control after pelvic floor muscle training. It is recommended that patients should control body weight reasonably while performing pelvic floor training. Pilates combined with Kegel training can promote the recovery of urinary control and pelvic floor muscle strength in patients with urinary incontinence after prostate surgery.

Availability of data and materials

Our Data is provided within the manuscript or supplementary information files.

References

  1. Filocamo MT, et al. Effectiveness of early pelvic floor rehabilitation treatment for post-prostatectomy incontinence. Eur Urol. 2005;48(5):734–8.

    Article  PubMed  Google Scholar 

  2. Overgård M, et al. Does Physiotherapist-guided pelvic floor muscle training reduce urinary incontinence after radical prostatectomy? A Randomised Controlled Trial. Eur Urol. 2008;54(2):438–48.

    Article  PubMed  Google Scholar 

  3. Kampen MV, et al. An easy prediction of urinary incontinence duration after Retropubic Radical Prostatectomy based on urine loss the First Day after Catheter Withdrawal. J Urol. 2009;181(6):2641–6.

    Article  PubMed  Google Scholar 

  4. Loughlin KR, Prasad MM. Post-prostatectomy urinary incontinence: a confluence of 3 factors. J Urol. 2010;183(3):871–7.

    Article  PubMed  Google Scholar 

  5. Bauer RM, et al. Postprostatectomy incontinence: all about diagnosis and management. Eur Urol. 2009;55(2):322–33.

    Article  PubMed  Google Scholar 

  6. Li X, et al. Urinary continence outcomes of four years of follow-up and predictors of early and late urinary continence in patients undergoing robot-assisted radical prostatectomy. BMC Urol. 2020;20(1):29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Milios JE, Ackland TR, Green DJ. Pelvic floor muscle training in radical prostatectomy: a randomized controlled trial of the impacts on pelvic floor muscle function and urinary incontinence. BMC Urol. 2019;19(1):116.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Burgio KL, et al. Behavioral vs drug treatment for urge urinary incontinence in older women: a randomized controlled trial. JAMA. 1998;280(23):1995–2000.

    Article  CAS  PubMed  Google Scholar 

  9. Schluter PJ, Arnold EP, Jamieson HA. Falls and hip fractures associated with urinary incontinence among older men and women with complex needs: a national population study. Neurourol Urodyn. 2018;37(4):1336–43.

    Article  PubMed  Google Scholar 

  10. Sanda MG, et al. Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med. 2008;358(12):1250–61.

    Article  CAS  PubMed  Google Scholar 

  11. John G, et al. Urinary incontinence as a marker of higher mortality in patients receiving home care services. BJU Int. 2014;113(1):113–9.

    Article  PubMed  Google Scholar 

  12. Nambiar AK, et al. EAU guidelines on Assessment and Nonsurgical Management of urinary incontinence. Eur Urol. 2018;73(4):596–609.

    Article  PubMed  Google Scholar 

  13. Abrams P, et al. 6th International Consultation on Incontinence. Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse and faecal incontinence. Neurourol Urodyn. 2018;37(7):2271–2.

    Article  PubMed  Google Scholar 

  14. Goode PS. Efficacy of an assisted low-intensity programme of perioperative pelvic floor muscle training in improving the recovery of continence after radical prostatectomy: a randomized controlled trial. BJU Int. 2012;110(7):1010–1.

    Article  PubMed  Google Scholar 

  15. An D, et al. Effect of different postures of Pilates combined with Kegel training on pelvic floor muscle strength in post-prostatectomy incontinence. Int Urol Nephrol. 2023;55(3):519–27.

    Article  PubMed  Google Scholar 

  16. Hodges PW, Sapsford R, Pengel LH. Postural and respiratory functions of the pelvic floor muscles. Neurourol Urodyn. 2007;26(3):362–71.

    Article  CAS  PubMed  Google Scholar 

  17. Flegal KM, et al. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013;309(1):71–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Mokdad AH, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003;289(1):76–9.

    Article  PubMed  Google Scholar 

  19. Subak LL, Richter HE, Hunskaar S. Obesity and urinary incontinence: epidemiology and clinical research update. J Urol. 2009;182(6 Suppl):S2–7.

    PubMed  PubMed Central  Google Scholar 

  20. Subak LL, et al. Does weight loss improve incontinence in moderately obese women? Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(1):40–3.

    Article  CAS  PubMed  Google Scholar 

  21. Subak LL, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360(5):481–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Dubbelman Y, et al. Quantification of changes in detrusor function and pressure-flow parameters after radical prostatectomy: relation to postoperative continence status and the impact of intensity of pelvic floor muscle exercises. Neurourol Urodyn. 2012;31(5):637–41.

    Article  PubMed  Google Scholar 

  23. Subak LL, et al. Weight loss: a novel and effective treatment for urinary incontinence. J Urol. 2005;174(1):190–5.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Wang, J. and D. An, Effect of Internet combined with pelvic floor muscle training on postpartum urinary incontinence. International Urogynecology Journal, 2023.

  25. An D, et al. Effects of Biofeedback Combined with Pilates Training on Post-prostatectomy Incontinence. Urology. 2021;155:152–9.

    Article  PubMed  Google Scholar 

  26. Goode PS, et al. Behavioral therapy with or without biofeedback and pelvic floor electrical stimulation for persistent postprostatectomy incontinence: a randomized controlled trial. JAMA. 2011;305(2):151–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Hagen S, et al. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. Lancet. 2014;383(9919):796–806.

    Article  PubMed  Google Scholar 

  28. Smither AR, et al. Quantifying the natural history of post-radical prostatectomy incontinence using objective pad test data. BMC Urol. 2007;7:2.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Santa Mina D, et al. A pilot randomized trial of conventional versus advanced pelvic floor exercises to treat urinary incontinence after radical prostatectomy: a study protocol. BMC Urol. 2015;15(1):94.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Seckiner I, et al. Correlations between the ICIQ-SF score and urodynamic findings. Neurourol Urodyn. 2007;26(4):492–4.

    Article  PubMed  Google Scholar 

  31. Hodges PW, et al. Reconsideration of pelvic floor muscle training to prevent and treat incontinence after radical prostatectomy. Urologic Oncology: Seminars Original Investigations. 2020;38(5):354–71.

    Article  PubMed  Google Scholar 

  32. McKay MA, Todd-Magel C, Copel L. Factors associated with the risk for falls in PACE participants. Geriatr Nurs. 2020;41(5):571–8.

    Article  PubMed  Google Scholar 

  33. Stania M, et al. Bioelectrical activity of the pelvic floor muscles during synchronous whole-body vibration – a randomized controlled study. BMC Urol. 2015;15(1):107.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Stafford RE, et al. Activation of the striated urethral sphincter to maintain continence during dynamic tasks in healthy men. Neurourol Urodyn. 2012;31(1):36–43.

    Article  PubMed  Google Scholar 

  35. Bø K, et al. Evidence for benefit of transversus abdominis training alone or in combination with pelvic floor muscle training to treat female urinary incontinence: a systematic review. Neurourol Urodyn. 2009;28(5):368–73.

    Article  PubMed  Google Scholar 

  36. Dias NT, et al. A pilates exercise program with pelvic floor muscle contraction: is it effective for pregnant women? A randomized controlled trial. Neurourol Urodyn. 2018;37(1):379–84.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Thanks for patients helping this study. Many thanks for Dr. Fan Zhang and Limin Liao.

Funding

This study was funded by the Capital’s Funds for Health Improvement and Research (No. 2022-1-6011) and China Rehabilitation Research Center (2023ZX-Q9) .

Author information

Authors and Affiliations

  1. Department of physiotherapy 2 (PT2), China Rehabilitation Research Center the School of Rehabilitation, Capital Medical University, NO 10, Jiaomen Beilu, Fengtai district, Beijing, 100068, China

    Di An, Miao Ye & Chunying Hu

  2. Department of Intensive Care Unit, Cancer Hospital Chinese Academy of Medical Science, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Beijing, China

    Jianxia Wang

  3. Department of Urology, China Rehabilitation Research Center, Fengtai district, Beijing, China

    Fan Zhang, Huafang Jing, Yi Gao, Huiling Cong & Juan Wu

  4. Department of physiotherapy 3(PT3), China Rehabilitation Research Center, Fengtai district, Beijing, China

    Guodong Su

  5. China Rehabilitation Research Center (CRRC), Department of Urology of Beijing Boai Hospital, Department of Urology of Capital Medical University, NO 10, Jiaomen Beilu, Beijing, 100068, China

    Limin Liao

Authors
  1. Di An
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jianxia Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fan Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Huafang Jing
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yi Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Huiling Cong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Guodong Su
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Miao Ye
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Chunying Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Juan Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Limin Liao
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Di An: project development, data collection, manuscript writing and manuscript modify. Jianxia Wang: manuscript writing, data collection. Fan Zhang , Juan Wu and Chunying Hu : project development and manuscript modify. Huafang Jing, Yi Gao, Huiling Cong, Miao Ye and Guodong Su: data collection. Limin Liao: project development.

Corresponding author

Correspondence to Limin Liao.

Ethics declarations

Ethics approval and consent to participate

The study was approved by the Ethics Committee of the China Rehabilitation Research Center (2023-041-01). All patients were given informed consent. All experiments were performed in accordance with relevant guidelines and regulations.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

An, D., Wang, J., Zhang, F. et al. Effect of Pilates combined with pelvic floor muscle training on continence of post-prostatectomy incontinence in patients with different body mass index. BMC Urol 24, 74 (2024). https://doi.org/10.1186/s12894-024-01451-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12894-024-01451-6

Keywords

BMC Urology

ISSN: 1471-2490

Contact us