Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Prevalence and incidence of pelvic floor disorders before and after hysterectomy for gynaecological cancer (#270)

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

Aims:

To investigate pelvic floor disorders, physical activity levels (PA) and health-related quality-of-life (HRQoL) in patients undergoing hysterectomy for gynaecological cancer, and to identify changes in pelvic floor disorders, HRQoL and PA before and after surgery.

Methods:

Longitudinal study of patients undergoing hysterectomy for gynaecological cancer. Outcomes were assessed at baseline (pre-surgery symptoms), 6-weeks and 3-months post-surgery using the ISI, PFDI-20 and FSFI, IPAQ-7 and EORTC-QLQ-C30. Changes over time were analysed using linear mixed models, and generalised estimating equations.

Results:

Of 277 eligible patients, 126 consented to participate. The majority had stage 1 cancer (62%) and the most common cancer was endometrial cancer (69%).  The prevalence of urinary incontinence was 66% pre-surgery and 59% 3-months post-surgery, while the prevalence of faecal incontinence was 12% pre-surgery and 14% 3-months post-surgery, these differences were not statistically significant. However, there was a significant decrease in the prevalence of pelvic floor symptoms (PFDI-20 MD=-14%; 95%CI -23,-5) and urogenital symptoms (UDI-6 subdomain MD=-20%; 95%CI -31,-9). The incidences of new urinary and faecal incontinence 3-months post-surgery were 10% and 8% respectively. Three-months post-surgery, 42% of participants reported sexual activity compared to 27% pre-surgery (p=0.003). The prevalence of dyspareunia was high in those who attempted penetrative intercourse both pre-surgery (n=11/17) and 3-months post-surgery (n=11/20). Only 39% of the participants met PA guidelines pre-surgery, increasing significantly to 53% 3-months post-surgery (p=0.020). EORTC-QLQ C30 global health status/QoL domain scores did not change significantly from pre-surgery (M=64.8/100; 95%CI 61.2,68.4) to 3-months post-surgery (M=69.4/100; 95%CI 65.6,73.2)(MD 4.6; 95%CI -0.6,9.8).

Conclusions:

Patients with gynaecological cancer experienced high rates of pelvic floor disorders before and after hysterectomy. New cases of urinary and faecal incontinence developed between pre-surgery and 3-months post-surgery. Physical activity increased significantly, and HRQoL did not change significantly over this time. Clinicians working with gynaecology-oncology patients undergoing hysterectomy may want to consider screening and providing treatment options for pelvic floor disorders.