Robyn Brennen1,2, Kuan-Yin Lin3, Linda Denehy4,5, Helena C Frawley6. 1. School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, 47-49 Moorooduc Highway, Melbourne, Victoria 3199 Australia. 2. Monash Health Community Continence Service, Specialist Clinics, Monash Health, Dandenong, Australia. 3. School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University; and Department of Physical Therapy, National Cheng Kung University, Tainan, Taiwan. 4. Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia. 5. Allied Health, Peter MacCallum Cancer Centre, Parkville, Australia. 6. School of Primary and Allied Health Care, Faculty of Medicine, Nursing; and Health Sciences, Monash University.
Abstract
OBJECTIVE: The aim of this systematic review was to identify, evaluate and synthesize the evidence from studies that have investigated the effect of nonsurgical, nonpharmacological, pelvic floor muscle interventions on any type of pelvic floor dysfunction or health-related quality of life in patients after any type of treatment for gynecological cancer. METHODS: Six electronic databases (Cochrane Library 2018, CINAHL 1982-2018, MEDLINE 1950-2018, EMBASE 1980-2018, PsycINFO 1806-2018, and EMCARE 1995-2018) were systematically searched in June 2018. Reference lists of identified articles were hand searched. Randomized controlled trials (RCTs), cohort studies, and case series were included if they investigated the effects of conservative treatments, including pelvic floor muscle training or dilator training, on bladder, bowel or sexual function in patients who had received treatment for gynecological cancer. Risk of bias was assessed using the Physiotherapy Evidence Database (PEDro) scale for RCTs and the Newcastle-Ottawa scale for cohort studies. RESULTS: Five RCTs and 2 retrospective cohort studies were included (n = 886). The results provided moderate-level evidence that pelvic floor muscle training with counseling and yoga or core exercises were beneficial for sexual function (SMD = -0.96, 95% CI = -1.22 to -0.70, I2 = 0%) and health-related quality of life (SMD = 0.63, 95% CI = 0.38 to 0.88, I2 = 0%) in survivors of cervical cancer, and very low-level evidence that dilator therapy reduced vaginal complications in survivors of cervical and uterine cancer (odds ratio [OR] = 0.37, 95% CI = 0.17 to 0.80, I2 = 54%). There were insufficient data for meta-analysis of bladder or bowel function. CONCLUSION: Conservative pelvic floor muscle interventions may be beneficial for improving sexual function and health-related quality of life in survivors of gynecological cancer. Given the levels of evidence reported in this review, further high-quality studies are needed, especially to investigate effects on bladder and bowel function. IMPACT: This review provides moderate level evidence for the role of pelvic floor rehabilitation to improve health outcomes in the gynecological cancer survivorship journey. Clinicians and health services should consider how to provide cancer survivors the opportunity to participant in supervised pelvic floor rehabilitation programs.
OBJECTIVE: The aim of this systematic review was to identify, evaluate and synthesize the evidence from studies that have investigated the effect of nonsurgical, nonpharmacological, pelvic floor muscle interventions on any type of pelvic floor dysfunction or health-related quality of life in patients after any type of treatment for gynecological cancer. METHODS: Six electronic databases (Cochrane Library 2018, CINAHL 1982-2018, MEDLINE 1950-2018, EMBASE 1980-2018, PsycINFO 1806-2018, and EMCARE 1995-2018) were systematically searched in June 2018. Reference lists of identified articles were hand searched. Randomized controlled trials (RCTs), cohort studies, and case series were included if they investigated the effects of conservative treatments, including pelvic floor muscle training or dilator training, on bladder, bowel or sexual function in patients who had received treatment for gynecological cancer. Risk of bias was assessed using the Physiotherapy Evidence Database (PEDro) scale for RCTs and the Newcastle-Ottawa scale for cohort studies. RESULTS: Five RCTs and 2 retrospective cohort studies were included (n = 886). The results provided moderate-level evidence that pelvic floor muscle training with counseling and yoga or core exercises were beneficial for sexual function (SMD = -0.96, 95% CI = -1.22 to -0.70, I2 = 0%) and health-related quality of life (SMD = 0.63, 95% CI = 0.38 to 0.88, I2 = 0%) in survivors of cervical cancer, and very low-level evidence that dilator therapy reduced vaginal complications in survivors of cervical and uterine cancer (odds ratio [OR] = 0.37, 95% CI = 0.17 to 0.80, I2 = 54%). There were insufficient data for meta-analysis of bladder or bowel function. CONCLUSION: Conservative pelvic floor muscle interventions may be beneficial for improving sexual function and health-related quality of life in survivors of gynecological cancer. Given the levels of evidence reported in this review, further high-quality studies are needed, especially to investigate effects on bladder and bowel function. IMPACT: This review provides moderate level evidence for the role of pelvic floor rehabilitation to improve health outcomes in the gynecological cancer survivorship journey. Clinicians and health services should consider how to provide cancer survivors the opportunity to participant in supervised pelvic floor rehabilitation programs.
Authors: Amelia Barcellini; Mattia Dominoni; Francesca Dal Mas; Helena Biancuzzi; Sara Carla Venturini; Barbara Gardella; Ester Orlandi; Kari Bø Journal: Front Med (Lausanne) Date: 2022-02-03
Authors: Hongmei Zhu; Di Zhang; Lei Gao; Huixin Liu; Yonghui Di; Bing Xie; Wei Jiao; Xiuli Sun Journal: Int J Environ Res Public Health Date: 2022-09-04 Impact factor: 4.614