Effectiveness of Pelvic Floor Muscle and Education-Based Therapies on Bladder, Bowel, Vaginal, Sexual, Psychological Function, Quality of Life, and Pelvic Floor Muscle Function in Females Treated for Gynecological Cancer: A Systematic Review.

IF 4.7 2区 医学 Q1 ONCOLOGY
Marie-Pierre Cyr, Tamara Jones, Robyn Brennen, Udari Colombage, Helena C Frawley
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Abstract

Purpose of review: Gynecological malignancies are prevalent in females, and this population is likely to experience symptoms of pelvic floor disorders and sexual dysfunction. Non-surgical, non-pharmaceutical conservative therapies, namely pelvic floor muscle (PFM) therapies and education-based interventions, could be beneficial for this population. The purpose of this systematic review was to examine the evidence regarding their effectiveness on bladder, bowel, vaginal, sexual, psychological function, quality of life, and PFM function in gynecological cancer populations.

Recent findings: Six databases were searched to identify studies employing any interventional study design, except case studies, to investigate the effect of PFM therapies, education-based interventions, or combined therapies on any outcome of interest. The search yielded 4467 results, from which 20 studies were included. Of these, 11 (55%) were RCTs, two (10%) were non-RCTs with two groups, and seven (35%) were non-RCTs with a single group. Findings suggest that combined (multimodal) therapies, specifically PFM (active > passive) + education therapies, appear more effective for vaginal, overall pelvic floor, sexual, and PFM function. PFM therapies (active and/or electrostimulation) may improve bladder outcomes. Limited evidence suggests PFM (active) + education therapies may improve bowel function. Conservative therapies may improve psychological function, although available data do not appear to favor a particular therapy. Given the conflicting findings regarding quality of life, no clear conclusions can be made. Interpretation of findings highlighted the importance of intervention dosage, adherence, and supervision for optimal effectiveness. Despite the limitations of the included studies, this review provides new and valuable insights for future research and clinical practice.

Abstract Image

盆底肌肉疗法和教育疗法对妇科癌症女性膀胱、肠道、阴道、性、心理功能、生活质量和盆底肌肉功能的影响:系统回顾
综述目的:妇科恶性肿瘤多发于女性,这类人群很可能会出现盆底功能紊乱和性功能障碍的症状。非手术、非药物的保守疗法,即盆底肌肉(PFM)疗法和以教育为基础的干预措施,可能对这一人群有益。本系统性综述旨在研究这些疗法对妇科癌症患者的膀胱、肠道、阴道、性功能、心理功能、生活质量以及盆底肌功能的有效性:对六个数据库进行了检索,以确定除病例研究外采用任何干预性研究设计的研究,以调查 PFM 疗法、基于教育的干预或综合疗法对任何相关结果的影响。搜索结果共 4467 项,其中包括 20 项研究。其中 11 项(55%)为研究性试验,2 项(10%)为两组非研究性试验,7 项(35%)为单组非研究性试验。研究结果表明,综合(多模式)疗法,特别是盆底肌肉运动疗法(主动 > 被动)+ 教育疗法,似乎对阴道、整体盆底、性功能和盆底肌肉运动功能更有效。PFM 疗法(主动和/或电刺激)可改善膀胱功能。有限的证据表明,PFM(主动)+ 教育疗法可改善排便功能。保守疗法可改善心理功能,但现有数据似乎并不倾向于某一种疗法。鉴于有关生活质量的研究结果相互矛盾,因此无法得出明确的结论。对研究结果的解释强调了干预剂量、依从性和监督对达到最佳效果的重要性。尽管纳入的研究存在局限性,但本综述为未来的研究和临床实践提供了有价值的新见解。
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来源期刊
CiteScore
8.50
自引率
0.00%
发文量
187
审稿时长
6-12 weeks
期刊介绍: This journal aims to review the most important, recently published clinical findings in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by cancer. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as cancer prevention, leukemia, melanoma, neuro-oncology, and palliative medicine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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