Natural history of pelvic floor disorders before and after hysterectomy for gynaecological cancer

IF 4.7 1区医学 Q1 OBSTETRICS & GYNECOLOGY

Bjog-An International Journal of Obstetrics and Gynaecology Pub Date : 2024-05-29 DOI:10.1111/1471-0528.17870

Robyn Brennen, Kuan Yin Lin, Linda Denehy, Sze-Ee Soh, Thomas Jobling, Orla M. McNally, Simon Hyde, Helena Frawley

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引用次数: 0

Abstract

Objective

To investigate the prevalence and severity of pelvic floor disorders (PFD), and the associations between treatment type and PFD, and cancer stage and PFD in patients before and after hysterectomy for gynaecological cancer; and the changes in outcomes over time.

Design

Longitudinal cohort study.

Setting

Gynaecological oncology outpatient clinics.

Population

Patients undergoing hysterectomy for endometrial, uterine, ovarian or cervical cancer.

Methods

Participants were assessed before, and 6 weeks and 3 months after hysterectomy. Changes over time were analysed using generalised estimating equations or linear mixed models. Associations were analysed using logistic regression models and analyses of variance.

Main outcome measures

Incontinence Severity Index, Pelvic Floor Distress Inventory-short form (PFDI-20), Female Sexual Function Index.

Results

Of 277 eligible patients, 126 participated. Prevalence rates of PFD were high before (urinary incontinence [UI] 66%, faecal incontinence [FI] 12%, sexual inactivity 73%) and after (UI 59%, FI 14%, sexual inactivity 58%) hysterectomy. Receiving adjuvant therapy led to moderate-to-very severe UI 3 months after surgery compared with surgery only (odds ratio 4.98, 95% CI 1.63–15.18). There was no association between treatment type and other PFD, or cancer stage and any PFD.

Conclusion

Prevalence of PFD was high before and after hysterectomy for gynaecological cancer. Moderate-to-very-severe UI was associated with adjuvant therapy.

Abstract Image

查看原文本刊更多论文

妇科癌症子宫切除术前后盆底功能紊乱的自然史。

目的研究妇科癌症子宫切除术前后患者盆底功能障碍（PFD）的患病率和严重程度、治疗类型与盆底功能障碍之间的关系、癌症分期与盆底功能障碍之间的关系，以及随时间推移结果的变化：纵向队列研究：人群：接受子宫切除术的患者：人群：因子宫内膜癌、子宫癌、卵巢癌或宫颈癌而接受子宫切除术的患者：方法：在子宫切除术前、术后 6 周和 3 个月对参与者进行评估。采用广义估计方程或线性混合模型分析随时间的变化。使用逻辑回归模型和方差分析对相关性进行分析：尿失禁严重程度指数、盆底压力清单-简表（PFDI-20）、女性性功能指数：结果：在277名符合条件的患者中，有126人参与。子宫切除术前（尿失禁[UI] 66%、大便失禁[FI] 12%、性生活不活跃 73%）和术后（尿失禁 59%、大便失禁 14%、性生活不活跃 58%）的盆底窘迫患病率都很高。与仅接受手术治疗相比，接受辅助治疗会导致术后 3 个月出现中度至非常严重的尿失禁（几率比 4.98，95% CI 1.63-15.18）。治疗类型与其他PFD、癌症分期与任何PFD之间均无关联：结论：在妇科癌症子宫切除术前后，PFD的发病率都很高。中度至非常严重的 UI 与辅助治疗有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bjog-An International Journal of Obstetrics and Gynaecology 医学-妇产科学

CiteScore

10.90

自引率

5.20%

发文量

345

审稿时长

3-6 weeks

期刊介绍： BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.