Introduction: Urinary incontinence is common after radical prostatectomy (RP). Kegel exercises can improve continence rates, but patient compliance is poor.
Purpose: This project identified patient barriers to Kegel exercises. Findings provide important factors of non-compliance that should be included in patient education.
Methods: 28 men diagnosed with localized prostate cancer and elected to undergo RP. At the one-week visit following RP, after Foley catheter removal, the nurse practitioner instructed patients in performing three Kegel exercises with 10 repetitions of each exercise done three times daily at home. At the one-month visit, patients completed the Kegel Exercise Barrier Questionnaire with the question of “How many times a day do you do the exercise?” and 10 statements regarding possible barriers to Kegel exercises in which the patients responded “yes” or “no/not applicable.” Content validity of the questionnaire was obtained by review of experts in the field of voiding dysfunction including urologists, physical therapists, and urology nurses in addition to pilot interviews with patients who had previously done the Kegel exercises after having undergone RP.
Results: The barrier indicated by the most number of patients was “body soreness,” which was selected by 10 (35.7%) patients performing the exercise an average of 2.5 exercises per day. The second most-frequently indicated barrier was “damage the area of surgery”; which was selected by 7 (25%) patients, performing the exercises an average of 2.4 times per day.
Conclusions: Pain and perceived possible damage to the surgical site are reported to be the main reasons underlying Kegel exercise noncompliance in patients with urinary incontinence following RP in this QI project. These findings may provide opportunity for nurses and other health professionals to educate patients on pain management strategies and general anatomy of the pelvic floor and site of surgery, especially within the first four weeks following RP.
After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice