The purpose of this study is to allow us to assess the effectiveness (or success) of starting pelvic floor physical therapy (i.e. exercises for your pelvic muscles) prior to HoLEP (holmium laser enucleation of the prostate) surgery for enlarged prostates in order to manage or prevent urinary incontinence (i.e. leaking) after surgery (i.e. post-operatively). Your pelvic floor refers to the muscles under your bladder along your pelvic bones that prevent you from leaking urine or stool. Traditionally, pelvic floor physical therapy is started after surgery and continued until urinary continence (i.e. no leaking of urine) is regained. We want to assess if beginning pelvic floor physical therapy prior to surgery (and continuing afterwards) reduces the time required to regain urinary continence following HoLEP.
Age: >=18 years of age
Sex: male sex assigned at birth (needs to have a prostate)
BMI: all BMI
Ethnic background: all ethnicities
Neurological disorders: patients with a history of a neurologic disorder that could affect muscle function, neurogenic bladder, lumbosacral spine pathology
Specific urologic conditions: patients with pre-operative indwelling catheter, urethral stricture greater than 1 centimeter in length or requiring dilation/incision, indwelling ureteral stent
History of pelvic radiation: patient with prior pelvic radiation will be excluded
Patients unable to give consent
Parallel
Preoperative pelvic floor physical therapy
BehavioralPelvic floor physical therapy to start before prostate surgery rather than after surgery.
Time to continence
Time to recover from transient postoperative stress urinary incontinence
Uroflow
urine flow rate (milliliters/second)
Post void residual
Residual urine after voiding (milliliters)
international prostate symptom score
validated questionnaire on urination symptoms
operative time
length of surgery (minutes)
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