The feasibility of pelvic floor training to treat urinary incontinence in women with breast cancer: a telehealth intervention trial

Abstract

Purpose To investigate the feasibility of recruiting into a pelvic floor muscle training (PFMT) program delivered via telehealth to treat urinary incontinence (UI) in women with breast cancer on aromatase inhibitors. Methods We conducted a pre-post single cohort clinical trial with 54 women with breast cancer. Participants underwent a 12-week PFMT program using an intra-vaginal pressure biofeedback device: femfit®. The intervention included eight supervised individual PFMT sessions over Zoom™ and a 12-week home exercise program. The primary outcome of this study was feasibility, specifically consent rate. Secondary outcomes which included prevalence and burden of UI measured using the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF), and pelvic floor muscle (PFM) strength measured as intravaginal squeeze pressure were compared using McNemar’s and paired t tests. Results The mean age of participants was 50 years (SD ± 7.3). All women who were eligible to participate in this study consented (n = 55/55, 100%). All participants reported that the program was beneficial and tailored to their needs. The results showed a statistically significant decline in the prevalence (percentage difference 42%, 95% CI 28, 57%) and burden (ICIQ-UI SF score mean change 9.4, 95% CI 8.5, 10.4) of UI post intervention. A significant increase in PFM strength was observed post-intervention (mean change 4.8 mmHg, 95% CI 3.9, 5.5). Conclusion This study indicated that PFMT delivered via telehealth may be feasible and potentially beneficial in treating stress UI in women with breast cancer. Further studies such as randomized controlled trials are required to confirm these results.

Telehealth in breast cancer following the coronavirus disease 2019 pandemic

“…The feasibility of pelvic floor training through video call for women with BC has also been studied, showing significantly positive results in terms of reduction of urinary incontinence post intervention. In a study by Colombage et al [ 43 ], using an intra-vaginal pressure biofeedback device, patients learned via video call how to use train their pelvic muscles and how to use the biofeedback device. They were also virtually supervised by a physiotherapist through the 12 weeks course of the study [ 43 ].…”

“…In a study by Colombage et al [ 43 ], using an intra-vaginal pressure biofeedback device, patients learned via video call how to use train their pelvic muscles and how to use the biofeedback device. They were also virtually supervised by a physiotherapist through the 12 weeks course of the study [ 43 ]. The study also reports that 81% of the participants had problems when using the intra-vaginal device alone and therefore, it was only used under supervision [ 43 ].…”

“…They were also virtually supervised by a physiotherapist through the 12 weeks course of the study [ 43 ]. The study also reports that 81% of the participants had problems when using the intra-vaginal device alone and therefore, it was only used under supervision [ 43 ].…”

“…Additionally, intra-vaginal pressure biofeedback device is another helpful device since it allows the assessment of pelvic functionality in patients. However, without proper live video guidance, many patients encountered difficulties using these methods [ 43 ]. This highlights the importance of combining home devices to proper professional support.…”

Pelvic floor muscle training delivered via telehealth to treat urinary and/or faecal incontinence after gynaecological cancer surgery: a single cohort feasibility study

“…To date, no studies have investigated telehealth-delivered PFMT to treat UI/FI after gynaecological cancer treatment without a clinical assessment. One study investigated the feasibility of telehealth-delivered PFMT to treat stress UI in women with breast cancer and found that it may be feasible and potentially beneficial [ 15 ]. However, we do not know if similar results will be observed in women with gynaecological cancer due to differences in demographics, and clinical and treatment characteristics between breast and gynaecological cancer survivors.…”