Potencial evocado miogênico vestibular em homens prostatectomizados com incontinência urinária: desenvolvimento de um teste diagnóstico

Abstract

Prostate cancer is the second most common cancer in men. In its early stages, it is a curable disease through surgical procedures, such as radical prostatectomy, which is the most commonly used procedure with highly satisfactory results. However, it can cause complications such as urinary incontinence, which have a major impact on the psychological, physical, social, economic and sexual spheres, compromising the patient's quality of life. Pelvic rehabilitation for patients with signs of urinary incontinence has gained more ground because it does not cause side effects and promotes better recovery through training of the pelvic floor muscles, the muscles responsible for urethral closure. In the search for devices that provide faster achievement of the therapeutic objective and responses with low signal variability, the innovative possibility of applying vestibular evoked myogenic potential applied to the pelvic floor to assess the muscle function responsible for urinary continence has emerged. This research was divided into three stages: the first, the technological development of a device capable of capturing the electrophysiological response of the pelvic floor that can be connected to the vestibular evoked myogenic potential device: a utility model patent and industrial design; the second stage, a systematic review with meta-analysis on the impact of the use of electromyographic biofeedback, one of the most widely used resources in the rehabilitation of prostatectomized men with urinary incontinence; and the third stage, a pilot clinical trial article on the application of vestibular evoked myogenic potential in the evaluation of the pelvic floor in men with post-prostatectomy incontinence. The results of each stage were a patent and industrial design of an endoanal probe with a safety mechanism; the meta-analysis identified that participants who received the treatment showed a 1.78 times greater risk of achieving continence compared to those who did not receive the treatment; and the pilot clinical trial identified early latency and greater wave amplitudes, demonstrating a better record of muscle gain.