The Effect of Pelvic Floor Rehabilitation on Lower Anterior Resection Syndrome After Colorectal Cancer Treatment

Abstract

Purpose Lower anterior resection (LAR) is the preferred surgical treatment of rectosigmoid or rectal cancers but is often associated with bowel dysfunction, termed Lower Anterior Resection Syndrome (LARS). Daily bowel dysfunction symptoms have a detrimental effect on quality of life (QOL). Pelvic floor rehabilitation (PFR) can improve pelvic floor function and QOL among patients with LARS. This quality improvement (QI) project seeks to assess prevalence of LARS within our population and develop and incorporate PFR for treatment and prevention of LARS. Methods A convenience sample of 20 patients met project inclusion and 13 participated. Individuals were categorized by diagnostic risk: “low risk”, “high risk”, and “established.” The intervention included 1-hour PFR sessions with the physical therapist (PT) and 5 minutes of daily self-led pelvic floor muscle exercises. Outcome questionnaires included the LARS Score and FiQOL Scale. Data were collected both pre and post CRC treatment. Results Overall prevalence of LARS was 76.9% and significantly higher than the retrospective cohort comparison rate of 21.8% (p < .001). Prevalence of major LARS was 89%, 83%, and 50% at initial, second, and third session, representing a 44% relative decrease. Embarrassment was significantly affected among individuals with major LARS, though ongoing PFR facilitated improvement. Conclusion PFR is a valuable adjunct therapy for LARS, with continued sessions decreasing overall prevalence among our cohort. Major LARS negatively impacts QOL measures early on in treatment but improves with continued PFR.