Impact of gynecologic cancer on pelvic floor disorder symptoms and quality of life: an observational study

Abstract

The objective of our observational prospective study was to investigate the severity and prevalence of urinary and pelvic floor disorders in gynecologic cancer survivors. All patients surviving gynecological cancer in the region as well as women receiving invitations to attend breast-screening checkups as the control population were asked to fill-in questionnaires assessing pelvic prolapse symptoms (PFDI-20, Wexner) and associated quality of life (PFIQ-7). Eighty-nine women were included in the cancer survivor group and 1088 in the control group. Pelvic floor symptoms (PFDI-20 questionnaire) were significantly worse in cancer survivors than in control women (score: 33.3 [14.6–74.1] vs. 20 [4.2–50.0], p = 0.0003). Urge incontinence was significantly worse in cancer survivors in both univariable (ORb = 2.061 [95% CI = 1.284–3.309], p = 0.0027) and multivariable analyses (ORa = 1.672 [95% CI = 1.014–2.758], p = 0.0442), as was fecal incontinence in univariable (ORb = 3.836 [95% CI = 1.710–8.602], p = 0.0011) and in multivariable (ORa = 3.862 [95% CI = 1.657–9.001], p = 0.0018) analyses. Women with benign hysterectomies had poorer quality of life and increased pelvic floor disorders compared to women with no history of surgery. Survivors of gynecological cancer experience significantly more pelvic floor symptoms and an associated reduction in quality of life.

Prevalence and impact of bladder and bowel disorders in women with breast cancer: A systematic review with meta‐analysis

“…We found the level of bother or severity of bladder and bowel symptoms to be slight in women with breast cancer, which is consistent with women without breast cancer 48 . However, it is quite feasible that in the context of cancer diagnosis, treatment and treatment recovery, the impact of a nonfatal condition such as a bladder or bowel disorder may be rated comparatively lower 49 . In this review, most studies collected data during or shortly after primary cancer treatment, using cancer‐specific questionnaires.…”

Urogynaecological Symptoms among Oncological Survivors and Impact of Oncological Treatment on Pelvic Floor Disorders and Lower Urinary Tract Symptoms. A Six-Month Follow-Up Study

“…The common embryological, topographic and functional origin of the genitourinary tract implies also the potential being present for collective adverse reactions during or after management of oncological condition [1]. Apart from the fact that knowledge of the anatomy and topography of the genitourinary tract is crucial in recommending and carrying out the least harmful although successful treatment, it must be kept in mind that subsequent radio-chemotherapy may also induce or exaggerate troublesome symptoms [2,3].…”

“…Moreover, both LUTS and PFD are associated with lower QoL, worse psycho-social functioning and emotional problems [8][9][10]. An international classification includes more than 100 malignant diseases, but studies on etiology, pathogenesis and treatment are limited to those occurring most frequently [1]. Nevertheless, the research on PFD and LUTS among oncological survivors still remains very limited.…”

Bowel dysfunction in survivors of gynaecologic malignancies

“…Concerning endometrial cancer, outcomes of the PORTEC-2 trial [28] reported higher FI and faecal urgency rates in patients who received EBRT (24% and 55%, respectively) than in those who were treated with BT (15 and 32%, respectively). Studies [29,30] have found that prevalence of FI was significantly higher in gynaecological cancer survivors compared to controls. However, both studies assessed anal continence by the Wexner score which does not take defecatory urgency into account, a very common symptom after radiotherapy.…”