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Diagnostics
Volume 15
Issue 22
10.3390/diagnostics15222881
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Continence Recovery After Radical Prostatectomy: Personalized Rehabilitation and Predictors of Treatment Outcome

by
Małgorzata Terek-Derszniak
1,
Danuta Gąsior-Perczak
2,3,
Małgorzata Biskup
1,2,
Tomasz Skowronek
1,
Mariusz Nowak
1,
Justyna Falana
4,
Jarosław Jaskulski
2,5,
Mateusz Obarzanowski
2,5,
Stanislaw Gozdz
2,4 and
Pawel Macek
2,6,*
1
Department of Rehabilitation, Holycross Cancer Centre, Artwinskiego 3, 25-734 Kielce, Poland
2
Collegium Medicum, Jan Kochanowski University in Kielce, Zeromskiego 5, 25-369 Kielce, Poland
3
Endocrinology Clinic, Holycross Cancer Centre, 25-734 Kielce, Poland
4
Oncology Clinic, Holycross Cancer Centre, Artwinskiego 3, 25-734 Kielce, Poland
5
Department of Urology, Holycross Cancer Centre, Artwinskiego 3, 25-734, Kielce, Poland
6
Scientific Research, Epidemiology and R&D Centre, Holycross Cancer Centre, Artwinskiego 3, 25-734 Kielce, Poland
*
Author to whom correspondence should be addressed.
Diagnostics 2025, 15(22), 2881; https://doi.org/10.3390/diagnostics15222881 (registering DOI)
Submission received: 27 August 2025 / Revised: 28 October 2025 / Accepted: 12 November 2025 / Published: 13 November 2025
(This article belongs to the Section Clinical Diagnosis and Prognosis)
Versions Notes

Abstract

Background/Objectives: Urinary incontinence (UI) remains a common and distressing complication following radical prostatectomy (RP). This prospective observational study aimed to assess the effectiveness of structured pelvic floor rehabilitation and to identify clinical and surgical predictors of continence recovery. Methods: A total of 182 patients undergoing RP received standardized physiotherapist-guided pelvic floor muscle training (PFMT), including supervised sessions before and after surgery, as well as individualized home exercise programs. UI severity was evaluated using a 1 h pad test and a four-level UI stage classification at three time points. The primary outcomes were changes in UI stage and the achievement of full continence, defined as a pad test result ≤2 g. Results: Following three rehabilitation sessions, 80.2% of patients regained full continence. Preoperative PFMT (β = −1.27, p = 0.0061) and shorter time to rehabilitation (β = −0.04, p = 0.0026) were associated with greater improvement in continence outcomes. Patients treated with robot-assisted RP showed a higher probability of continence recovery compared to those undergoing laparoscopic RP, particularly in the presence of moderate to severe baseline incontinence. Higher baseline urinary leakage significantly decreased the odds of treatment success (β = −0.01, p = 0.0001). ISUP grade and extraprostatic extension were not independently associated with outcomes. Conclusions: Despite the absence of a control group, this study demonstrates the effectiveness of structured and personalized pelvic floor rehabilitation in improving post-RP continence. Early initiation and preoperative training should be prioritized to optimize recovery in routine clinical practice.
Keywords: urinary incontinence; radical prostatectomy; pelvic floor muscle training; continence recovery; robot-assisted radical prostatectomy; pad test; physiotherapy; predictive factors urinary incontinence; radical prostatectomy; pelvic floor muscle training; continence recovery; robot-assisted radical prostatectomy; pad test; physiotherapy; predictive factors

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MDPI and ACS Style

Terek-Derszniak, M.; Gąsior-Perczak, D.; Biskup, M.; Skowronek, T.; Nowak, M.; Falana, J.; Jaskulski, J.; Obarzanowski, M.; Gozdz, S.; Macek, P. Continence Recovery After Radical Prostatectomy: Personalized Rehabilitation and Predictors of Treatment Outcome. Diagnostics 2025, 15, 2881. https://doi.org/10.3390/diagnostics15222881

AMA Style

Terek-Derszniak M, Gąsior-Perczak D, Biskup M, Skowronek T, Nowak M, Falana J, Jaskulski J, Obarzanowski M, Gozdz S, Macek P. Continence Recovery After Radical Prostatectomy: Personalized Rehabilitation and Predictors of Treatment Outcome. Diagnostics. 2025; 15(22):2881. https://doi.org/10.3390/diagnostics15222881

Chicago/Turabian Style

Terek-Derszniak, Małgorzata, Danuta Gąsior-Perczak, Małgorzata Biskup, Tomasz Skowronek, Mariusz Nowak, Justyna Falana, Jarosław Jaskulski, Mateusz Obarzanowski, Stanislaw Gozdz, and Pawel Macek. 2025. "Continence Recovery After Radical Prostatectomy: Personalized Rehabilitation and Predictors of Treatment Outcome" Diagnostics 15, no. 22: 2881. https://doi.org/10.3390/diagnostics15222881

APA Style

Terek-Derszniak, M., Gąsior-Perczak, D., Biskup, M., Skowronek, T., Nowak, M., Falana, J., Jaskulski, J., Obarzanowski, M., Gozdz, S., & Macek, P. (2025). Continence Recovery After Radical Prostatectomy: Personalized Rehabilitation and Predictors of Treatment Outcome. Diagnostics, 15(22), 2881. https://doi.org/10.3390/diagnostics15222881

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