Non-Invasive Pelvic Floor Rehabilitation in Cancer Population: An Incomplete Cohort

Overview

Journal Pain Physician

Date 2022 Oct 26

PMID 36288598

Authors

Carlos J Roldan

Anumol Thomas

Nichole Samms

Lei Feng

Billy Huh

Affiliations

Soon will be listed here.

Abstract

Background: Pelvic floor dysfunction and its associated symptoms are a common clinical challenge in the cancer population. Despite the noninvasive nature of pelvic floor rehabilitation (PFR) for this condition and the promising clinical results observed with its use, PFR appears to be an underused therapy.

Objectives: The purpose of this study was to quantify the association between physical therapy of the pelvic floor and its effect on pain relief and the associated symptoms in cancer patients with pelvic floor dysfunction.

Study Design: Retrospective cohort study.

Methods: With the use of an electronic database in our pain medicine department, we retrospectively quantified the pain relief and symptom improvement in patients diagnosed as having chronic pelvic floor dysfunction who had undergone PFR.

Results: Of the 68 patients available for analysis, 49 met the inclusion criteria. Baseline characteristics of included patients were generally similar. The duration of pelvic pain before PFR was 53.7 months (mean) (SD, 182.5 months; median, 12 months). Of the 49 study patients, 23 (47%) had bladder dysfunction, 24 (49%) had dyspareunia, 2 (4%) had erectile dysfunction, and one (2%) had rectal dysfunction. Most symptoms associated with pelvic floor dysfunction resolved after PFR.

Limitations: Single-center, small data, retrospective study.

Conclusions: PFR is an effective tool for treating the pain associated with pelvic floor dysfunction and its related symptoms. This conservative approach can contribute to lowering the use of opiate analgesics.

References

Kilic M . Incidence and risk factors of urinary incontinence in women visiting Family Health Centers. Springerplus. 2016; 5(1):1331. PMC: 4980849. DOI: 10.1186/s40064-016-2965-z. View

Tandberg D, REED W . Blood cultures following rectal examination. JAMA. 1978; 239(17):1789. View

Akuthota V, Nadler S . Core strengthening. Arch Phys Med Rehabil. 2004; 85(3 Suppl 1):S86-92. DOI: 10.1053/j.apmr.2003.12.005. View

Cyr M, Dumoulin C, Bessette P, Pina A, Gotlieb W, Lapointe-Milot K . Feasibility, acceptability and effects of multimodal pelvic floor physical therapy for gynecological cancer survivors suffering from painful sexual intercourse: A multicenter prospective interventional study. Gynecol Oncol. 2020; 159(3):778-784. DOI: 10.1016/j.ygyno.2020.09.001. View

Whitehead W, Bharucha A . Diagnosis and treatment of pelvic floor disorders: what's new and what to do. Gastroenterology. 2010; 138(4):1231-5, 1235.e1-4. PMC: 3924316. DOI: 10.1053/j.gastro.2010.02.036. View

Brennen R, Lin K, Denehy L, Frawley H . The Effect of Pelvic Floor Muscle Interventions on Pelvic Floor Dysfunction After Gynecological Cancer Treatment: A Systematic Review. Phys Ther. 2020; 100(8):1357-1371. DOI: 10.1093/ptj/pzaa081. View

Beketie E, Tafese W, Assefa Z, Berriea F, Tilahun G, Shiferaw B . Symptomatic pelvic floor disorders and its associated factors in South-Central Ethiopia. PLoS One. 2021; 16(7):e0254050. PMC: 8248712. DOI: 10.1371/journal.pone.0254050. View

Butrick C . Pathophysiology of pelvic floor hypertonic disorders. Obstet Gynecol Clin North Am. 2009; 36(3):699-705. DOI: 10.1016/j.ogc.2009.08.006. View

Ghaderi F, Bastani P, Hajebrahimi S, Jafarabadi M, Berghmans B . Pelvic floor rehabilitation in the treatment of women with dyspareunia: a randomized controlled clinical trial. Int Urogynecol J. 2019; 30(11):1849-1855. PMC: 6834927. DOI: 10.1007/s00192-019-04019-3. View

10.

Hurtado E, Appell R . Management of complications arising from transvaginal mesh kit procedures: a tertiary referral center's experience. Int Urogynecol J Pelvic Floor Dysfunct. 2008; 20(1):11-7. DOI: 10.1007/s00192-008-0721-9. View

11.

Rosenbaum T, Owens A . The role of pelvic floor physical therapy in the treatment of pelvic and genital pain-related sexual dysfunction (CME). J Sex Med. 2008; 5(3):513-23. DOI: 10.1111/j.1743-6109.2007.00761.x. View

12.

Hong M, Ding D . Current Treatments for Female Pelvic Floor Dysfunctions. Gynecol Minim Invasive Ther. 2019; 8(4):143-148. PMC: 6849106. DOI: 10.4103/GMIT.GMIT_7_19. View

13.

Tu F, Holt J, Gonzales J, Fitzgerald C . Physical therapy evaluation of patients with chronic pelvic pain: a controlled study. Am J Obstet Gynecol. 2008; 198(3):272.e1-7. DOI: 10.1016/j.ajog.2007.09.002. View

14.

Roldan C, Hu N . Myofascial Pain Syndromes in the Emergency Department: What Are We Missing?. J Emerg Med. 2015; 49(6):1004-10. DOI: 10.1016/j.jemermed.2015.04.027. View

15.

Faubion S, Shuster L, Bharucha A . Recognition and management of nonrelaxing pelvic floor dysfunction. Mayo Clin Proc. 2012; 87(2):187-93. PMC: 3498251. DOI: 10.1016/j.mayocp.2011.09.004. View

16.

Gupta P, Gaines N, Sirls L, Peters K . A multidisciplinary approach to the evaluation and management of interstitial cystitis/bladder pain syndrome: an ideal model of care. Transl Androl Urol. 2016; 4(6):611-9. PMC: 4708537. DOI: 10.3978/j.issn.2223-4683.2015.10.10. View

17.

Yaacov D, Nelinger G, Kalichman L . The Effect of Pelvic Floor Rehabilitation on Males with Sexual Dysfunction: A Narrative Review. Sex Med Rev. 2021; 10(1):162-167. DOI: 10.1016/j.sxmr.2021.02.001. View

18.

Weiss J . Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. J Urol. 2001; 166(6):2226-31. DOI: 10.1016/s0022-5347(05)65539-5. View

19.

Boyadzhyan L, Raman S, Raz S . Role of static and dynamic MR imaging in surgical pelvic floor dysfunction. Radiographics. 2008; 28(4):949-67. DOI: 10.1148/rg.284075139. View

20.

Good M, Solomon E . Pelvic Floor Disorders. Obstet Gynecol Clin North Am. 2019; 46(3):527-540. DOI: 10.1016/j.ogc.2019.04.010. View