Fecal Incontinence Affecting Quality of Life and Social Functioning Among Long-Term Gynecological Cancer Survivors

Dunberger, Gail; Lind, Helena; Steineck, Gunnar; Waldenström, Ann-Charlotte; Nyberg, Tommy; al-Abany, Massoud; Nyberg, Ullakarin; Åvall‐Lundqvist, Elisabeth

doi:10.1111/igc.0b013e3181d373bf

Cited by 49 publications

(67 citation statements)

References 27 publications

(17 reference statements)

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“…The time point is appropriate, as little change was seen in continence later than 12 mo after surgery [16,17]. The questionnaire used the same clinometric approaches as those used previously [18][19][20][21][22]. The questionnaire included 39 questions about urinary function, most of which have been used before [14,23,24] As measures of effect, we report unadjusted relative risk ratios (RRs), calculated with log-binomial regression models and, due to lack convergence of log-binomial models, unadjusted and adjusted odds ratios (ORs) calculated with logistic regression models (Supplementary …”

Section: Methodsmentioning

confidence: 99%

Urinary Incontinence and Erectile Dysfunction After Robotic Versus Open Radical Prostatectomy: A Prospective, Controlled, Nonrandomised Trial

et al. 2015

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Section: Methodsmentioning

confidence: 99%

Urinary Incontinence and Erectile Dysfunction After Robotic Versus Open Radical Prostatectomy: A Prospective, Controlled, Nonrandomised Trial

et al. 2015

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“…In our study, several women described casual sexual relationships as unthinkable and even women who lived in a stable relationship described a concern for leakage in the sexual context. This gives a deeper understanding to the previous observation that 25 % of 64 GCS experiencing faecal leakage without forewarning stated that leakage has hindered their sexual activity, compared to 3 % of 524 women without faecal leakage without forewarning [21]. It is important to consider GCS’s QoL from several different dimensions since QoL is a subjective experience that must accommodate all aspects of a person’s life situation [22].…”

Section: Discussionmentioning

confidence: 82%

Experiences of incontinence and pelvic floor muscle training after gynaecologic cancer treatment

Lindgren

Dunberger

Enblom

2016

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PurposeThe purpose of the present study is to describe how gynaecological cancer survivors (GCS) experience incontinence in relation to quality of life, their possibilities for physical activity and exercise and their perceptions and experiences of pelvic floor muscle training.MethodThis qualitative interview content analysis study included 13 women (48–82 age) with urinary (n = 10) or faecal (n = 3) incontinence after radiation therapy (n = 2), surgery (n = 5) and surgery and radiation therapy (n = 6) for gynaecological cancer, 0.5–21 years ago.ResultSymptoms related to incontinence and restrictions in daily activities reduced physical quality of life. Emotions related to incontinence reduced psychological quality of life and social and existential quality of life, due to restrictions in activity and feelings of exclusion. Practical and mental strategies for maintaining quality of life were described, such as always bringing a change of clothes and accepting the situation. Possibilities for sexual and physical activity as well as exercise were also restricted by incontinence. The women had little or no experience of pelvic floor muscle training but have a positive attitude towards trying it. They also described a lack of information about the risk of incontinence. The women were willing to spend both money and time on an effective treatment for their incontinence. Nine out of 10 were willing to spend at least 7 h a week.ConclusionGCS experienced that incontinence reduced quality of life and limited possibilities for sexual and physical activity as well as exercise. Coping strategies, both practical and emotional, facilitated living with incontinence. The women had a positive attitude towards pelvic floor muscle training. Lack of information had a negative impact on their way of dealing with the situation.

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“…Patient-reported data were collected before and 3, 12 and 24 months after surgery via validated questionnaires administered and collected by a neutral third party 5 . The study questionnaires reporting patient outcomes have the same clinometric approach as a previous randomized controlled trial and more than twenty large-sized data collections of cancer survivors 789 . The validation of the questionnaires and the pilot study performed before study-start has been described earlier 5 .…”

Section: Methodsmentioning

confidence: 99%

Oncological and functional outcomes 1 year after radical prostatectomy for very‐low‐risk prostate cancer: results from the prospective LAPPRO trial

et al. 2016

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Objectives To analyse oncological and functional outcomes 12 months after treatment of very low risk prostate cancer with radical prostatectomy in men who could have been candidates for active surveillance. Patients and Methods A prospective study of all men with very low risk prostate cancer who underwent radical prostatectomy at 14 participating centres. Validated patient questionnaires were collected at base line and after 12 months by independent health-care researchers. Biochemical recurrence (BCR) was defined as PSA ≥ 0.25 ng/ml or treatment with salvage radiotherapy or treated with hormones. Urinary continence was defined as "less than one pad changed per 24 hour". Erectile function was defined as ”erection hard enough for penetration more than half of the time after sexual stimulation”. Changes in tumor grade and stage were obtained from pathology reports. We show descriptive frequencies and proportions having each outcome in various subgroups. Fisher’s exact test was used to assess differences between the age groups. Results Of the 4003 men in the LAPPRO cohort, 338 men fulfilled the preoperative national criteria for very low risk prostate cancer. Adverse pathology outcomes included: upgrading, defined as pT3 or postoperative Gleason sum ≥ 7, was present in 35% (115/333), positive surgical margins, 16% (54/329). Only 7/329 men (2.1%) had PSA concentration > 0.1 ng/ml 6–12 weeks postoperatively. Erectile function and urinary continence were 44% (98/222) and 84% (264/315) 12 months postoperatively. Trifecta defined as preoperative potent and continent men that remained potent and continent with no BCR was at 12 months 38 % (84/221). Conclusions Our prospective study of men with very low risk prostate cancer undergoing open or robotic radical prostatectomy showed favourable oncological outcome in about two-thirds. About 40 per cent did not suffer from surgically induced urinary incontinence or erectile dysfunction 12 months postoperatively. These results provide additional support for the use of active surveillance in men with very low risk prostate cancer, however the group of men with risk of upgrading and upstaging is not negligible. Improved stratification is still an urgently needed.

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Fecal Incontinence Affecting Quality of Life and Social Functioning Among Long-Term Gynecological Cancer Survivors

Abstract: Among gynecological cancer survivors having undergone pelvic radiotherapy alone or as part of a combined treatment, fecal incontinence is associated with social, psychological, sexual, and functional consequences.

Cited by 49 publications

References 27 publications

Urinary Incontinence and Erectile Dysfunction After Robotic Versus Open Radical Prostatectomy: A Prospective, Controlled, Nonrandomised Trial

Urinary Incontinence and Erectile Dysfunction After Robotic Versus Open Radical Prostatectomy: A Prospective, Controlled, Nonrandomised Trial

Experiences of incontinence and pelvic floor muscle training after gynaecologic cancer treatment

Oncological and functional outcomes 1 year after radical prostatectomy for very‐low‐risk prostate cancer: results from the prospective LAPPRO trial

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