TPUS Quantification of Bladder Neck Displacement after verbal instructions

INSTRUCTIONS TO “STOP THE URINE FLOW” PRIOR TO RADICAL PROSTATE SURGERY PRODUCES QUANTIFIABLE BLADDER NECK ELEVATION USING TRANSPERINEAL ULTRASOUND

Presenter: Neumann P

This module addresses:

Questions: Does the verbal instruction to “stop the flow of urine” result

in appropriate cranial displacement of the bladder neck in men undergoing

radical prostate surgery? Can this movement be reliably quantified by a

trained physiotherapist using transperineal ultrasound in the clinic?

Conclusion: Prior to radical prostate surgery, verbal instructions to

contract the pelvic floor muscles “as if stopping the flow of urine” resulted

in cranial bladder neck displacement which could be accurately quantified

in the clinical setting by transperineal ultrasound performed by a trained

physiotherapist. The relevance of this instruction to focus on urethral,

compared with anal, sphincter activation on continence outcomes is not

known and warrants further research.

Key Practice Points:

• Instructions to “stop the flow of urine” resulted in bladder neck elevation

in all men

• Transperineal ultrasound can provide quantifiable and accurate measures

of pelvic floor movement in pre-prostatectomy men in the clinical setting

CPD Points: 0.25