A New Frontier in BPE Treatment: Intersection of Pelvic Floor Muscle Training & LUTS

• Published in: Journal of Urological Surgery
• Main Authors: Gautam Shubhankar, Pooja Nigade
• Format: Article
• Language: English
• Published: Society of Urological Surgery 2025-09-01
• Subjects: bpe; luts; pfmt; constipation
• Online Access: https://jurolsurgery.org/articles/a-new-frontier-in-bpe-treatment-intersection-of-pelvic-floor-muscle-training-andamp-luts/doi/jus.galenos.2025.2025-3-6

Objective: Lower urinary tract symptoms (LUTS) associated with benign prostatic enlargement (BPE) are common among ageing men. Emerging evidence suggests a strong interplay between pelvic floor dysfunction and LUTS, often exacerbated by underlying constipation, whether clinically apparent or subclinical. Pelvic floor muscle training (PFMT), a well-established intervention for constipation, may offer therapeutic benefits in BPE-related LUTS. However, limited literature exists on its efficacy in this context. Materials and Methods: This multicentric, prospective, double-arm comparative observational study was conducted over six months at two institutions. Patients with BPE and LUTS were enrolled and divided into two groups. Group I received an alpha-blocker (Silodosin 8 mg) alone, while group II received Silodosin 8 mg plus PFMT. Baseline and post-treatment assessments at six weeks included International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), and post-void residual (PVR) volume. Results: One hundred and ten patients were included (group I: 53, group II: 57). Both groups demonstrated significant improvements in LUTS after six weeks, but group II showed superior outcomes. IPSS reduction was significantly greater in group II (15±4 vs. 13±3 in group I, p=0.003). Qmax improved more in group II (12.4±1.5 mL/sec vs. 11.1±0.9 mL/sec, p=0.001), and PVR reduction was more pronounced in this group (71±22 mL vs.83±23 mL, p=0.006). Conclusion: The addition of PFMT to standard medical therapy significantly improved LUTS in patients with BPE. This novel intervention, irrespective of constipation status, enhances urinary outcomes and warrants further investigation through larger clinical trials.