Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Is telehealth pelvic floor muscle training feasible to treat incontinence after gynaecological cancer? (#269)

Robyn Brennen 1 2 , Sze-Ee Soh 3 , Linda Denehy 1 4 , Kuan-Yin Lin 5 , Tom Jobling 6 , Orla McNally 1 4 7 , Simon Hyde 1 8 , Jennifer Kruger 9 , Helena Frawley 1 7 8
  1. University of Melbourne, Carlton, VIC, Australia
  2. University of South Australia, Adelaide, SA, Australia
  3. Monash University, Frankston, Vic, Australia
  4. Peter MacCallum Cancer Centre, Melbourne, Vic, Austraia
  5. National Taiwan University, New Taipei, Taiwan
  6. Monash Health, Moorabbin, Vic, Australia
  7. Royal Women's Hospital, Melbourne, Vic, Australia
  8. Mercy Hospital for Women, Heidelberg, Vic, Australia
  9. University of Auckland, Auckland, New Zealand

Aim:

To assess the feasibility of telehealth-delivered pelvic floor muscle training for patients with incontinence after gynaecological cancer surgery.

Design:

Pre-post single cohort clinical trial.

Methods:

Women with urinary and/or faecal incontinence after gynaecological cancer surgery underwent a 12-week physiotherapist-supervised telehealth-delivered pelvic floor muscle training program. The intervention involved seven videoconference sessions with real-time feedback from an intravaginal biofeedback device, and a daily home exercise program using a mobile app. Feasibility outcomes included the proportion of eligible patients recruited, attendance at videoconference sessions, and adherence to the home exercise program.  Participant satisfaction and acceptability was rated on a 7-point scale  ranging from 1=very unsatisfied/very unacceptable to 7=very satisfied/very acceptable.

Clinical outcomes were assessed at baseline, immediately post-intervention and at three-months follow-up using the ICIQ-UI-SF, the ICIQ-B and the intravaginal biofeedback device. Means and 95%CIs were analysed using bootstrapping methods.

Results:

A total of 63 women were eligible, of which 39 (62%) consented to the study. Three participants did not complete baseline outcome measures and were not enrolled in the trial. Of the 36 participants who enrolled in the trial, 32 (89%) received the intervention. The majority (n=30, 94%) demonstrated high engagement, attending at least six videoconference sessions. Adherence was moderate, with 24 participants (75%) completing five-to-seven pelvic floor muscle training sessions per week during the intervention. Three months after intervention, 24 participants (77%) rated the videoconference sessions 'very acceptable',14 (44%) rated the intravaginal sensor 'very acceptable', and 25 (78%) reported doing regular PFMT.

All clinical outcome measures improved immediately post-intervention, however the magnitudes of these improvements were small. At three-months follow-up, improvements were sustained for prevalence, ICIQ-UI-SF and ICIQ-B domains but not PFM outcomes.

Conclusion:

Telehealth-delivered pelvic floor muscle training is a feasible and acceptable option to treat incontinence after gynaecological cancer surgery. Large randomised controlled trials are warranted to investigate clinical effectiveness and cost-effectiveness.