Aims: To examine associations between (1) treatment type or stage of cancer and pelvic floor symptoms after hysterectomy for gynaecological cancer, and (2) pelvic floor symptoms and both physical activity and health-related quality-of-life after hysterectomy for gynaecological cancer.
Design: Longitudinal observational study.
Methods: Patients undergoing hysterectomy for gynaecological cancer were assessed before and 3-months after surgery. Pelvic floor symptoms were assessed using the Incontinence Severity Index and Pelvic Floor Distress Inventory short form (PFDI-20). Physical activity was assessed using the International Physical Activity Questionnaire short form and health-related quality-of-life was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ C30). Associations were analysed using logistic regression models and analyses of variance.
Results: Of 277 eligible patients, 126 participated in this study. Sixty-four participants (50.8%) received surgery only and sixty participants (47.6%) received surgery and adjuvant or neo-adjuvant therapy. Participants who had adjuvant/neo-adjuvant therapy were more likely to experience moderate-to-severe urinary incontinence 3-months after surgery than those who had surgery only (OR=4.98; 95%CI 1.63,15.18). There was no association between treatment type and other pelvic floor symptoms, or stage of cancer and any pelvic floor symptoms. Pelvic floor symptoms were not associated with physical activity levels. Participants reporting pelvic floor symptoms on the PFDI-20 had lower scores on the EORTC-QLQ C30 global health status/QoL domain compared to those who did not report pelvic floor symptoms on the PFDI-20 (MD=-9.59; 95%CI -17.8,-1.81).
Conclusions: Adjuvant therapy may increase the odds of developing moderate-to-severe urinary incontinence. Pelvic floor symptoms may have a negative impact on health-related quality-of-life after gynaecological cancer treatment.