Vaginal symptoms in women who are affected by gynecologic cancer

[Efficacy of pelvic rehabilitation in managing sexual dysfunctions secondary to gynecological cancer: Systematic review of reviews]

The systematic review synthesized the current scientific evidence on the recommendations for pelvic rehabilitation in the management of sexual dysfunctions secondary to gynecological cancer. Twelve literature reviews, systematic reviews, and meta-analyses were included, evaluating the methodological quality using the Joanna Briggs Institute Risk of Bias Assessment tool. The results highlight the efficacy of pelvic floor exercises, alone or with biofeedback, and education and information provided to patients, with a high degree of recommendation. Vaginal dilators, and manual techniques received a moderate recommendation due to inconclusive protocols and high risk of bias. Early initiation of pelvic rehabilitation is recommended, but variability was identified in the intervention protocols, which hinders the comparison of the efficacy of the treatments.

Pelvic Floor Therapy and Initial Interventions for Pelvic Floor Dysfunction in Gynecologic Malignancies

PURPOSE OF REVIEW

This review provides evidence-based updates for the first-line management approaches for pelvic floor disorders in patients with gynecologic malignancies, as well as important provider considerations when referring for pelvic floor physical therapy.

RECENT FINDINGS

Currently, there is strong evidence to recommend pelvic floor muscle training as initial treatment for urinary incontinence and for pelvic organ prolapse; some evidence to recommend a more targeted pelvic floor muscle training program for fecal incontinence; and mostly expertise-based evidence to recommend vaginal gels or estrogen to aid with dyspareunia causing sexual dysfunction. More research is greatly needed to understand the role of overactive pelvic floor muscles in survivors with chronic pelvic pain and the treatment of post-radiation pelvic complications such as vaginal stenosis and cystitis. While pelvic floor disorders are common concerns in gynecologic cancer survivors, there are evidence-based initial noninvasive treatment approaches that can provide relief for many individuals.

Physiotherapy interventions in the treatment of pelvic floor dysfunctions after gynaecological oncology procedures: a systematic review

Cancer is one of the leading causes of death worldwide and a large percentage of cancer in women include gynaecological neoplasms. The aim of the review was to investigate the possibilities and effectiveness of physiotherapeutic techniques in the treatment of pelvic floor dysfunction after gynaecological oncology procedures. The review was performed in PubMed, Embase and PEDro databases. 5,561 articles were found, however only 11 met the inclusion criteria and were included in the review. To assess the risk of bias of included studies RoB-2 tool, ROBINS-1 were used. Ten studies were assessed as "low" and one study was asses as "moderate" risk. Studies have shown that the most common physiotherapeutic method described to treat pelvic floor dysfunction are pelvic floor muscle training, followed by biofeedback, electrostimulation, and behavioural training. Extracorporeal magnetic innervation is among the innovative method used in the treatment of UI among women who have overcome gynaecological cancer. On the other hand, in the treatment of sexual disorders, a vaginal dilator and pelvic floor training are used. Overall, pelvic floor training appears to be an effective technique in the treatment of pelvic floor dysfunction after the treatment of gynaecological malignancies. A small amount of research, a large variety of types of cancer, different methods of measuring results and small research trials make it difficult to accurately compare the results and draw appropriate conclusions.