For prostate cancer patients with well-differentiated tumors and a life expectancy of over 10 years, prostatectomy is the standard treatment. However, surgery may damage pelvic structures, leading to bladder dysfunction and pelvic floor muscle weakness, resulting in postoperative urinary incontinence. This study explores whether postoperative exercise intervention can improve incontinence and reduce inflammation.

This quasi-experimental study was conducted at a urology department in a teaching hospital in northern Taiwan, involving 32 prostate cancer patients who underwent Da Vinci prostatectomy. Participants were randomly assigned to a control group (n=10) and two experimental groups (n=11 each). Experimental groups underwent 12 weeks of pelvic floor muscle training (low-intensity) or combined pelvic floor and core muscle training (high-intensity) post-surgery. All three groups received one course of extracorporeal magnetic wave therapy (6 sessions) during outpatient follow-up. One-way ANOVA was used to compare urinary incontinence volume in the 24-hour pad test among groups and assess the improvement effects. Additionally, ELISA was used to measure changes in cortisol, TNF-α, and IL-6 levels in blood.

No significant differences were found in demographic and disease-related characteristics. Analysis of total urinary incontinence showed that the exercise training group had significantly better results than the control group after 12 weeks (p < 0.05), with no significant difference in improvement based on exercise intensity. Blood analysis showed a significant decrease in cortisol levels after exercise, with the low-intensity group showing statistically significant differences compared to both the no-exercise and high-intensity groups. TNF-α levels gradually decreased post-intervention, indicating reduced inflammation and tissue regeneration, with the low-intensity group showing significant differences compared to the other groups. IL-6 levels decreased over time in all groups post-surgery, with the exercise intervention group showing a significantly greater reduction compared to the control group.

In patients who underwent robotic radical prostatectomy, pelvic floor muscle training 12 weeks post-surgery significantly improved urinary incontinence and reduced leakage. Exercise intensity did not significantly affect the improvement. Low-intensity exercise reduced stress hormones, decreased inflammation, promoted tissue repair, and accelerated wound healing, possibly aiding in incontinence recovery.