Speaker
Description
Pelvic floor symptoms following robotic-assisted laparoscopic prostatectomy (RALP) can reduce participation in meaningful activities, including exercise. Although pelvic floor physical therapy is becoming a standard intervention for post-prostatectomy patients with symptoms like stress urinary incontinence (SUI), there is limited guidance to safely progress patients into higher-impact activities like running. Evidence-based postpartum pelvic floor rehabilitation programs effectively help women return to running, but have not been studied in males returning to running after prostate cancer treatment. This case report applies an evidence-based protocol, Rehabilitation of the Postpartum Runner: A 4-Phase Approach, in a novel way to address SUI and pelvic girdle weakness post-RALP.
A 60-year-old male with pT3a, R0 prostate cancer with positive extra-capsular extension and perineural invasion presented post-operatively following radical prostatectomy. He reported SUI with all transitional movements. He demonstrated global hip weakness and reduced pelvic girdle stability. He was an avid runner (3-7 miles daily) pre-operatively, but was unable to walk short distances without significant leakage at evaluation. His goal was to return to running daily without leakage.
Use of the Rehabilitation of the Postpartum Runner: A 4-Phase Approach over 15 weeks for asymptomatic return to running. The framework includes progression of hip, core, and pelvic floor musculature’s neuromuscular control and load tolerance, and safe mileage advancement.
All Running Readiness Scale Evaluation Criteria passed. Patient returned to running, work, and recreational activities symptom-free, with 0-1 pad use. The minimal detectable change was exceeded for the NIH-Chronic Prostatitis Symptom Index. Global improvements in lower extremity and pelvic girdle strength were observed.
Minimal research is available to guide returning to running after RALP. Despite being designed for female runners with post-partum pelvic floor weakness, the Rehabilitation of the Postpartum Runner 4-phase approach should be considered for post-operative prostatectomy pelvic floor weakness to facilitate a safe, symptom-free return to high-impact exercise.
Keywords
Stress urinary incontinence, radical prostatectomy, cancer rehabilitation, return to running, pelvic health
| Abstract submitters declaration | yes |
|---|---|
| Conflict of Interest & Ethical Approval | yes |
