医学与外科泌尿学
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HIFEM Procedure Enhances the Quality of Life in Elderly Men with Post-Prostatectomy Incontinence: A Pilot Study

Javier Azparren, Judson Brandeis

Objective: Post-Prostatectomy Incontinence (PPI) is a common and bothersome side effect of the surgery, which may be persistent. This pilot study aims to document the change in the Quality of Life (QoL) of subjects with PPI treated by the HIFEM procedure.

Patients and methods: Ten male subjects (72.90 ± 3.90 years) with a history of prostatectomy accompanied by persistent PPI were recruited. They received six 28-minute HIFEM treatments spaced two treatments per week. Change in the subject’s QoL was monitored using a standardized King’s Health Questionnaire (KHQ) at the baseline and after the last therapy. A 24-hour pad usage questionnaire assessed the usage of absorbent pads. Data was statistically analyzed and tested for normality (α = 5%).

Results: Each of the 10 (ten) patients showed improvement in QoL after HIFEM treatments. KHQ score decreased significantly in both parts of the questionnaire by 27.0% and 34.4% respectively (30.8 points in Part I, P=0.002; 107.5 points in Part II, P=0.001), revealing that subjects improved most in the domains: Incontinence impact (-30.4%; 23.3 points; P=0.01), social limitations (-42.2%; 21.1 points; P=0.01), emotions (-42.5%; 18.9 points; P<0.001), role limitations (-31.4%; 18.3 points; P=0.03), and sleep/energy (-53.3%; 13.3 points; P=0.04). All of the differences in domain scores exceeded the minimal clinical significance difference of 5 points. All ten subjects were using absorbent pads at the baseline. Post-treatment, patients reported reduction in pad usage of 1.0 absorbent pad per day on average. Additionally, two subjects were completely pad-free after the last therapy. The HIFEM procedure was concluded to be safe without any adverse event occurrence.

Conclusion: This pilot study investigating the therapeutic effects of the HIFEM procedure in a male population has shown a significant improvement in all domains of QoL as per KHQ immediately following the last treatment. Available data points towards a promising solution for PPI, giving the affected men their lives back.