Evaluation of Pelvic Floor Muscle Function(PFMF) In Cervical Cancer Patients With Querleu-Morrow Type C Hysterectomy: A Multicenter Study

Abstract

Introduction To evaluate the pelvic floor muscle function (PFMF) of cervical cancer patients after type QM-C hysterectomy and to explore the relationship between decreased PFMF and related factors..Methods This was a multi-centered retrospective cohort study. 181 cervical cancer patients who underwent type QM-C hysterectomy were enrolled from 9 tertiary hospitals. Strength of PFMF were measured by using neuromuscular apparatus (Phenix U8, French). Risk factors contributing to decreased PFMF were analyzed by univariate and multivariate ordinal ploytomous logistic regression. Results Totally 181 patients were investigated in this study. 0-3 level of type I muscle fibre strength(MFSI) was 52.6% (95/181), 0-3 level of type ⅡA muscle fibre strength(MFSⅡA) was 50% (91/181). Subjective stress urinary incontinence was 46%(84/181), urinary retention was 27.3% (50/181), dyschezia was 41.5% (75/181), fecal incontinence was 9%(18/181). ① MFSI：Multivariate ordinal ploytomous logistic regression shows that the follow-up time(p<0.05), chemotherapy and radiotherapy (p=0.038) are independent risk factors of MFSI’s reduction after type QM-C hysterectomy. ② MFSⅡA：Multivariate ordinal ploytomous logistic regression shows that the follow-up time (p<0.05) are independent risk factors of MFSⅡA’s reduction after type QM-C hysterectomy. The pelvic floor muscle strength (PFMS) increased after 9 months than in 9 months after operation, which showed that the PFMS could be recovered after operation. Conclusions We advocate for more attention and emphasis on the PFMF of Chinese female patients with cervical cancer postoperation.Contribution of the Paper PFMF after QM-C hysterectomy has not been analyzed by current study. The contribution is that patients with radical hysterectomy should do pelvic floor rehabilitation exercises in 3 months after operation.