Impact of gynecologic cancer on pelvic floor disorder symptoms and quality of life: an observational study

Mathias Neron, Sophie Bastide, Renaud de Tayrac, Florent Masia, Catherine Ferrer, Majd Labaki, Laurent Boileau, Vincent Letouzey, Stephanie Huberlant, Mathias Neron, Sophie Bastide, Renaud de Tayrac, Florent Masia, Catherine Ferrer, Majd Labaki, Laurent Boileau, Vincent Letouzey, Stephanie Huberlant

Abstract

The objective of our observational prospective study was to investigate the severity and prevalence of urinary and pelvic floor disorders in gynecologic cancer survivors. All patients surviving gynecological cancer in the region as well as women receiving invitations to attend breast-screening checkups as the control population were asked to fill-in questionnaires assessing pelvic prolapse symptoms (PFDI-20, Wexner) and associated quality of life (PFIQ-7). Eighty-nine women were included in the cancer survivor group and 1088 in the control group. Pelvic floor symptoms (PFDI-20 questionnaire) were significantly worse in cancer survivors than in control women (score: 33.3 [14.6-74.1] vs. 20 [4.2-50.0], p = 0.0003). Urge incontinence was significantly worse in cancer survivors in both univariable (ORb = 2.061 [95% CI = 1.284-3.309], p = 0.0027) and multivariable analyses (ORa = 1.672 [95% CI = 1.014-2.758], p = 0.0442), as was fecal incontinence in univariable (ORb = 3.836 [95% CI = 1.710-8.602], p = 0.0011) and in multivariable (ORa = 3.862 [95% CI = 1.657-9.001], p = 0.0018) analyses. Women with benign hysterectomies had poorer quality of life and increased pelvic floor disorders compared to women with no history of surgery. Survivors of gynecological cancer experience significantly more pelvic floor symptoms and an associated reduction in quality of life.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow chart.
Figure 2
Figure 2
Boxplot comparing PFDI-20 global score of (A) cancer survivor (CS) to control group (CG) and (B) cancer survivors (CS) to women who underwent benign hysterectomy (CGH+) and women with no history of cancer or hysterectomy (CGH−). Global score ranges from 0 to 300, higher scores represent more symptoms and associated discomfort.
Figure 3
Figure 3
Boxplot comparing PFIQ-7 global score of (A) cancer survivor (CS) to control group (CG) and (B) cancer survivors (CS) to women who underwent benign hysterectomy (CGH+) and women with no history of cancer or hysterectomy (CGH−). Global score ranges from 0 to 300, higher scores represent a stronger impact of symptoms on quality of life.

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