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Aims: In this prospective controlled randomized trial we assessed the effects of early, intensive, prolonged pelvic floor exercises (PFE) on urinary incontinence following bladder neck (BN) sparing RRP. Methods: A sample of 152 patients with localized prostate cancer underwent RRP with BN preservation. Out of this group we randomized 107 incontinent patients into 2 groups. We considered incontinent patients with 24 hr Pad test >2 g. The T group received instructions regarding an intensive program of PFE, from 7 days after catheter removal for as long as any degree of incontinence persisted, within a period of 1 year. The control (C) group did not receive instructions. The outcome was assessed using the 24 hr Pad test, a visual analogue scale (VAS) and a single question of QoL. Results at baseline and at 1, 3, 6, and 12 months were available for 54 and 40 patients, respectively. Results: The overall spontaneous continence rate after catheter removal was 23.6%. The proportion of men still incontinent was significantly higher in the C group than treatment (T) group at 1 (97.5% vs. 83.3%; P ¼ 0.04), 3 (77.5% vs. 53.7%; P ¼ 0.03), 6 (60% vs. 33.3%; P ¼ 0.01), and 12 months (52.5% vs. 16.6%; P < 0.01). Similarly, the VAS and the response to the QoL question at 12 months significantly differed between the two groups (P ¼ 0.01 and 0.03, respectively). Conclusions: Our study suggests that early intensive prolonged PFE can further increase the number of continent patients and this improvement persists in the first 12 months. The second 6 months following surgery are still useful to recovery. Neurourol. Urodynam. 26:985–989, 2007. 2007 Wiley-Liss, Inc.

Prostatic inflammation is widespread in the male population. Two groups of 50 patients each with symptoms of prostatic inflammation and ecocolorDoppler indicative of prostatitis were identified. Both groups were further subdivided into two subgroups (respectively A1, A2, B1, and B2). Group A1 underwent therapy with oral levofloxacin 500 mg daily for 10 days plus co-treatment with oral Serenoa repens (320 mg) plus Bromeline plus Nettle (Prostamev Plus®) daily for two months; Group A2 with oral levofloxacin 500 mg daily for 10 days plus oral Serenoa repens extract 320 mg/day for two months; Group B1 specific antibiotic treatment for 10 days (included levofloxacin if sensitive) plus co-treatment with oral Serenoa repens (320 mg) plus Bromeline plus Nettle (Prostamev Plus®) daily for two months; Group B2 with specific antibiotic treatment for 10 days plus Serenoa repens 320 mg/day for two months. The groups treated with Prostamev Plus® in comparison to the groups treated with Serenoa repens extract (saw palmetto) achieved better improvements of both IPSS score, urinary flow and sexual life.

To detect obstruction in patients with LUTS suggestive of BPH comparing the prostatic intravesical protrusion detected by abdominal ultrasounds with uroflowmetry testing results with urodynamic study to make evidence of obstruction.A series of 25 patients (mean age 67.9 years) at the first visit for BPH problems, underwent to routine examination including: abdominal ultrasound examination, TRUS, uroflowmetry IPSS and QoL questionnaires and urodynamic evaluation. We evaluated the degree in mm of prostatic intravesical protrusion by ultrasounds with a bladder volume between 150-220 cc. The degree of protrusion was classified as mild (5 mm), moderate (5-10 mm) and severe (10 mm), Qmax was divided in obstructed (10 ml/s), equivocal (10-15 ml/s) and unobstructed (15 ml/s). Confirmation or not of obstruction was validated by urodynamic study.mean prostate volume was 41.4cc; IPSS 22.4; Quality of Life 4.0; post voided residual urine 97.8 cc; DAMPF 62.6; Schäfer 3.4; Qmax 9.9 ml/s. Almost all the patients with severe protrusion had obstructed flow confirmed by P/F study. Patients with severe protrusion and unobstructedflow have obstruction compensated by high pressure voiding.These results, despite of the numbers of patients, suggest that the degree of prostatic protrusion measured by abdominal ultrasounds is a data that, if correlated to obstructed Qmax, can be used in the evaluation of BPH patients and their grade of obstruction.