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Cyr MP, Jones T, Brennen R, Colombage U, Frawley HC. 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. Curr Oncol Rep 2024:10.1007/s11912-024-01586-7. [PMID: 39177709 DOI: 10.1007/s11912-024-01586-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2024] [Indexed: 08/24/2024]
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.
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Affiliation(s)
- Marie-Pierre Cyr
- School of Health and Rehabilitation Sciences, The University of Queensland, Therapies Annex, 84a Services Rd, St Lucia, Brisbane, QLD, 4067, Australia.
| | - Tamara Jones
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Robyn Brennen
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia
- Department of Physiotherapy, University of South Australia, Adelaide, SA, Australia
| | - Udari Colombage
- Department of Physiotherapy, Monash University, Melbourne, VIC, Australia
| | - Helena C Frawley
- School of Health Sciences, The University of Melbourne, Alan Gilbert Building, 161 Barry St, Carlton, Melbourne, VIC, 3010, Australia.
- The Royal Women's Hospital, Melbourne; Mercy Hospital for Women, Melbourne, VIC, Australia.
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Pehlivan MJ, Sherman KA, Wuthrich V, Gandhi E, Zagic D, Kopp E, Perica V. The effectiveness of psychological interventions for reducing poor body image in endometriosis, PCOS and other gynaecological conditions: a systematic review and meta-analysis. Health Psychol Rev 2024; 18:341-368. [PMID: 37675797 DOI: 10.1080/17437199.2023.2245020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/01/2023] [Indexed: 09/08/2023]
Abstract
Gynaecological conditions (e.g., endometriosis, PCOS) result in bodily changes that negatively impact body image. Psychological interventions (e.g., CBT, psychoeducation) have shown promise in reviews with the general population for alleviating body image concerns. This systematic review and meta-analysis aims to provide asynthesis of the impact of psychological interventions for reducing body image concerns for individuals with gynaecological conditions. Electronic databases were searched for relevant psychological intervention studies with body image outcomes. Twenty-one eligible studies were included in the systematic review (ten were included in a random-effects meta-analysis). Studies included participants (N = 1483, M = 71.85, SD = 52.79) with a range of gynaecological conditions, ages (Mage = 35.08, SD = 12.17) and cultural backgrounds. Most included studies reported at least one positive effect with the meta-analysis indicating psychological interventions were moderately superior to control conditions for reducing body image concerns (SMD -.41, 95% CI [-0.20 -0.62]). However, there was a high risk of bias and moderate heterogeneity. Results suggest psychological interventions may hold promise for reducing body image concerns among individuals gynaecological conditions in the short term. Further, preliminary support was found for the use of theory-guided psychological interventions delivered in group settings in particular, with further research needed on optimal intervention length and particular psychotherapeutic approach.
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Affiliation(s)
- Melissa J Pehlivan
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Kerry A Sherman
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Viviana Wuthrich
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Esther Gandhi
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Dino Zagic
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Emily Kopp
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Valentina Perica
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
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Cyr MP, Camden C, Dumoulin C, Dostie R, Bessette P, Pina A, Gotlieb WH, Lapointe-Milot K, Mayrand MH, Morin M. Gynecological Cancer Survivors' Experiences of Dyspareunia and Factors Influencing Care-Seeking Behavior: A Qualitative Study. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2669-2681. [PMID: 37058221 DOI: 10.1007/s10508-023-02589-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 01/15/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
Pain during sexual intercourse, also called dyspareunia, affects most women after treatment for gynecological cancer. Previous work adopted a biomedical approach to depict dyspareunia in this population, which provided a narrow perspective of this condition. Taking into account women's experiences of dyspareunia and the factors influencing their care-seeking behaviors would provide insight to improve care in the context of gynecological cancer. The aim of this study was to describe gynecological cancer survivors' experiences of dyspareunia and factors influencing care-seeking behavior. A qualitative study was performed with 28 gynecological cancer survivors with dyspareunia. Individual telephone interviews were conducted based on the Common-Sense Model of Self-Regulation. Interviews were recorded and transcribed for analysis using the interpretative description framework. Concerning their experience, participants reported the oncological treatments as the primary cause of dyspareunia. Loss of libido, lower vaginal lubrication, and smaller vaginal cavity were described as being linked with dyspareunia. Women explained how dyspareunia and these changes had led them to engage less in, and even interrupt, sexual activity. They expressed that they were distressed, felt less of a woman, and experienced low control and/or self-efficacy. Regarding the factors influencing women's care-seeking behaviors, participants emphasized that they were provided with insufficient information and support. Balancing priorities, denial or reluctance, misbeliefs, resignation and acceptance, and negative emotions were reported as barriers, whereas acknowledgement of sexual dysfunction, desire for improvement, awareness of treatment possibilities, willingness to undertake treatment and treatment acceptability were reported as facilitators to seeking care. Findings suggest that dyspareunia is a complex and impactful condition after gynecological cancer. While this study highlights the importance of alleviating the burden of sexual dysfunction in cancer survivors, it identified factors that should be considered in the provision of services to improve care.
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Affiliation(s)
- Marie-Pierre Cyr
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12E Avenue N, Sherbrooke, QC, J1H 5N4, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Chantal Camden
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12E Avenue N, Sherbrooke, QC, J1H 5N4, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Chantale Dumoulin
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Research Center of the Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Rosalie Dostie
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12E Avenue N, Sherbrooke, QC, J1H 5N4, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Paul Bessette
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Annick Pina
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Walter Henry Gotlieb
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Korine Lapointe-Milot
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-Hélène Mayrand
- Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Departments of Obstetrics and Gynecology and Social and Preventive Medicine, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Mélanie Morin
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12E Avenue N, Sherbrooke, QC, J1H 5N4, Canada.
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.
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Fernández-Pérez P, Leirós-Rodríguez R, Marqués-Sánchez MP, Martínez-Fernández MC, de Carvalho FO, Maciel LYS. Effectiveness of physical therapy interventions in women with dyspareunia: a systematic review and meta-analysis. BMC Womens Health 2023; 23:387. [PMID: 37482613 PMCID: PMC10364425 DOI: 10.1186/s12905-023-02532-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 07/08/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Dyspareunia is defined as the occurrence of pain during or after sexual intercourse, which directly affects physical, sexual, and mental health. This condition can lead to depression, anxiety, and low self-esteem in women who experience it. OBJECTIVES The aim of this research was to evaluate the effectiveness of physical therapy interventions for the treatment of female dyspareunia. DESIGN A systematic review and meta-analysis was conducted. METHOD Search of publications was conducted in Scopus, Medline, Pubmed, Cinahl and Web of Science. Treatment effects were defined as standardized mean difference and their 95% confidence intervals. Statistical heterogeneity was assessed using Crohan's Q test and quantified using the I2 index. RESULTS Of the 19 articles selected, six applied multimodal physiotherapy treatments; five, electrotherapy; three, Thiele's massage; two, interdisciplinary interventions or pelvic floor muscle training; and one, extracorporeal shockwave therapy. The meta-analysis showed significant results for the variables pain and quality of life with the interventions based on electrotherapy and electrotherapy combined with pelvic floor muscle training. These interventions did not show significant results for the improvement of sexual function. CONCLUSIONS Physiotherapy techniques are effective and procedures have been identified with reliable results in improving pain and quality of life in patients with dyspareunia. One of the most important aspects is the strengthening of the perineal musculature and the application of Transcutaneous Electrical Nerve Stimulation. Furthermore, manual trigger point release therapy and Thiele massage, optimize and guarantee the reduction of pain intensity. PROSPERO REGISTRATION CRD42021236155.
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Affiliation(s)
- Paula Fernández-Pérez
- Nursing and Physical Therapy Department, University of Leon, Astorga Ave, 24401 Ponferrada, Spain
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of Leon, Astorga Ave, 24401 Ponferrada, Spain
| | - Mª Pilar Marqués-Sánchez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of Leon, Astorga Ave, 24401 Ponferrada, Spain
| | | | | | - Leonardo Y. S. Maciel
- Physical Therapy Department of Lagarto, Universidade Federal de Sergipe, Gov. Marcelo Déda Ave, São José, Lagarto 49400-000 Brazil
- Faculty of Sport, Research Centre in Physical Activity, Health and Leisure (CIAFEL), University of Porto, R. Dr. Plácido da Costa 91, 4200-450 Porto, Portugal
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Bernard S, Tandon P, Waters A, Selmani S, Wiebe E, Turner J, Dufour S, McNeely ML. Preferences, barriers and facilitators regarding virtual pelvic healthcare in individuals with gynaecological cancers: protocol for a patient-oriented, mixed-methods study. BMJ Open 2023; 13:e067606. [PMID: 36697045 PMCID: PMC9884898 DOI: 10.1136/bmjopen-2022-067606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Vaginal pain during intercourse and urinary incontinence are common complaints after gynaecological cancer treatments. Pelvic health physiotherapy treatments aim at optimising function through education on the use of vaginal moisturisers, dilation therapy programme and pelvic floor muscle training. Given that barriers such as time, travel, and costs are known to limit access to physiotherapy services, a virtual pelvic health physiotherapy programme may help to facilitate access. The primary objective of this study is to identify preferences, barriers and facilitators from individuals with gynaecological cancer regarding virtual pelvic healthcare survivorship care. METHODS AND ANALYSIS This patient-oriented, mixed-methods study will involve an online cross-sectional survey data (phase I) and qualitative data from a series of virtual focus groups (phase II). PHASE I an anonymous survey will be used to assess the demographics, health status, prevalence of urogenital symptoms, as well as knowledge, barriers and facilitators to pelvic health services of people with gynaecological cancer. A total of N=50 participants from Canada will be recruited through convenience and self-selection sampling. PHASE II a series of virtual semi-structured focus groups will be conducted with 10-15 participants on key topics related to virtual pelvic healthcare. Interviews will be audio-recorded and transcribed, from which key themes and quotes will be identified. An interpretive description qualitative method will guide analysis and implementation of results. ETHICS AND DISSEMINATION Approval from the Health Research Ethics Board of Alberta-Cancer Committee (HREBA.CC-21-0498) and of the CISSS Bas-Saint-Laurent (CISSSBSL-2021-10) have been obtained. Informed, electronically signed consent will be required from all participants. Results from this work will be published in a peer-reviewed journal and will be used to inform the development and implementation of a new Pelvic eHealth Module for individuals treated for gynaecological cancers. This module will be incorporated into a comprehensive educational and exercise programme offered by a web-based application.
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Affiliation(s)
- Stéphanie Bernard
- Department of Physical Therapy, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Puneeta Tandon
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Alexandra Waters
- Département de radio-oncologie, Centre Intégré de Santé et de Services Sociaux du Bas-St-Laurent, Rimouski, Québec, Canada
| | - Sabrina Selmani
- Département de radio-oncologie, Centre Intégré de Santé et de Services Sociaux du Bas-St-Laurent, Rimouski, Québec, Canada
| | - Ericka Wiebe
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Cross Cancer Institute, Alberta Health Services, Edmonton, Alberta, Canada
| | - Jill Turner
- Cross Cancer Institute, Alberta Health Services, Edmonton, Alberta, Canada
| | - Sinead Dufour
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Margaret L McNeely
- Department of Physical Therapy, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Cross Cancer Institute, Alberta Health Services, Edmonton, Alberta, Canada
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Nappi RE, Tiranini L, Cucinella L, Martini E, Bosoni D, Righi A, Cassani C, Gardella B. Pharmacotherapy for female sexual dysfunctions (FSDs): what is on the market and where is this field heading? Expert Opin Pharmacother 2023; 24:135-143. [PMID: 35430926 DOI: 10.1080/14656566.2022.2066997] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Female sexual dysfunctions (FSDs) are common in women of any age and have a huge impact on quality of life and relationships. They have a multifaceted etiology limiting the development of pharmacotherapies with a high rate of effectiveness. Safety issues are also a concern. AREAS COVERED The authors report the most recent advances in pharmacotherapy for premenopausal and postmenopausal women with a main focus on hypoactive sexual desire disorders (HSDD) and associated sexual symptoms. Good levels of evidence have emerged for psychoactive agents, such as flibanserin and bremelanotide, as well as hormonal compounds (transdermal testosterone). The authors also report briefly on intravaginal DHEA (prasterone), local estrogen therapy (LET), and ospemifene to manage effectively vulvovaginal atrophy/genitourinary syndrome of menopause (VVA/GSM). In addition, they discuss promising therapeutic options highlighting the main reasons that hamper the availability of new labeled products. Finally, they include the importance of the multimodal approach to address FSDs. EXPERT OPINION Approved pharmacotherapies for FSD are limited. Validated multidimensional instruments and adequate objective measures of physical and mental responses to sexual external and internal incentives are mandatory to identify women suitable to chronic or on-demand treatments and to assess their pattern of response in research and practice.
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Affiliation(s)
- Rossella E Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Lara Tiranini
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Laura Cucinella
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Ellis Martini
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - David Bosoni
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Alessandra Righi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Chiara Cassani
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,Unit of Obstetrics and Gynecology, IRCCS S. Matteo Foundation, Pavia, Italy
| | - Barbara Gardella
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,Unit of Obstetrics and Gynecology, IRCCS S. Matteo Foundation, Pavia, Italy
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Cyr MP, Dostie R, Camden C, Dumoulin C, Bessette P, Pina A, Gotlieb WH, Lapointe-Milot K, Mayrand MH, Morin M. Acceptability of multimodal pelvic floor physical therapy to treat dyspareunia after gynecological malignancies: a qualitative study of women's views and experiences. Int Urogynecol J 2022; 34:1061-1073. [PMID: 35947187 PMCID: PMC9364276 DOI: 10.1007/s00192-022-05304-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/04/2022] [Indexed: 11/28/2022]
Abstract
Introduction and hypothesis Multimodal pelvic floor physical therapy (PFPT) is recommended after gynecological malignancies to treat dyspareunia. However, data to strongly support its implementation in the cancer care continuum are lacking. The aim of this study was to explore the views and experiences of gynecological cancer survivors with dyspareunia regarding the acceptability of multimodal PFPT. Methods This qualitative study was conducted with the participants (n = 28) of a study investigating a 12-week multimodal PFPT treatment. Individual semi-structured telephone interviews served to collect qualitative data pertaining to women’s views and experiences of the treatment they received. Interviews were recorded and transcribed for analysis using the interpretative description framework. Results Our cohort described the appropriateness of the treatment in terms of modalities, physical therapist, care delivery, and intensity (Theme 1). While the intensity was reported as demanding by a few, all participants stressed that it was relevant to see significant improvements (Theme 2). In addition to the treatment characteristics and women’s beliefs and attitudes, noticing the treatment effects motivated their participation (Theme 2). Women expressed being highly satisfied with the treatment based on their positive experiences and the balance between their efforts and the results they obtained (Theme 3). As a result, they all recommended this treatment (Theme 3). Conclusions This is the first study to examine the acceptability of multimodal PFPT in the context of gynecological malignancies. This treatment was found acceptable and can be offered to gynecological cancer survivors. Supplementary Information The online version contains supplementary material available at 10.1007/s00192-022-05304-4.
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Affiliation(s)
- Marie-Pierre Cyr
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5N4, Canada.,Research Center of the Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5H3, Canada.,School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, 84a Services Road, St Lucia, Brisbane, Queensland, 4072, Australia
| | - Rosalie Dostie
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5N4, Canada.,Research Center of the Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5H3, Canada
| | - Chantal Camden
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5N4, Canada.,Research Center of the Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5H3, Canada
| | - Chantale Dumoulin
- School of Rehabilitation, Faculty of Medicine, University of Montreal, 7077 Park Avenue, Montreal, Quebec, H3N 1X7, Canada.,Research Center of the Institut Universitaire de Gériatrie de Montréal, 4545 Queen Mary, Montreal, Quebec, H3W 1W6, Canada
| | - Paul Bessette
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5H3, Canada.,Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Annick Pina
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, University of Montreal, PO Box 6128, Centre-ville Station, Montreal, Quebec, H3C 3J7, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, 900 St Denis St, Montreal, Quebec, H2X 0A9, Canada
| | - Walter Henry Gotlieb
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, McGill University, 1001 Decarie Blvd, Montreal, Quebec, H4A 3J1, Canada.,Lady Davis Institute of the Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, H3T 1E2, Canada
| | - Korine Lapointe-Milot
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5H3, Canada.,Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Marie-Hélène Mayrand
- Research Center of the Centre Hospitalier de l'Université de Montréal, 900 St Denis St, Montreal, Quebec, H2X 0A9, Canada.,Departments of Obstetrics and Gynecology and Social and Preventive Medicine, Faculty of Medicine, University of Montreal, PO Box 6128, Centre-ville Station, Montreal, Quebec, H3C 3J7, Canada
| | - Mélanie Morin
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5N4, Canada. .,Research Center of the Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5H3, Canada.
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8
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Changes in pelvic floor morphometry and muscle function after multimodal physiotherapy for gynaecological cancer survivors suffering from dyspareunia: a prospective interventional study. Physiotherapy 2022; 114:54-62. [DOI: 10.1016/j.physio.2021.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 08/19/2021] [Accepted: 09/27/2021] [Indexed: 12/19/2022]
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Cyr MP, Dostie R, Camden C, Dumoulin C, Bessette P, Pina A, Gotlieb WH, Lapointe-Milot K, Mayrand MH, Morin M. Improvements following multimodal pelvic floor physical therapy in gynecological cancer survivors suffering from pain during sexual intercourse: Results from a one-year follow-up mixed-method study. PLoS One 2022; 17:e0262844. [PMID: 35077479 PMCID: PMC8789131 DOI: 10.1371/journal.pone.0262844] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/06/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND A large proportion of gynecological cancer survivors suffer from pain during sexual intercourse, also known as dyspareunia. Following a multimodal pelvic floor physical therapy (PFPT) treatment, a reduction in pain and improvement in psychosexual outcomes were found in the short term, but no study thus far has examined whether these changes are sustained over time. PURPOSE To examine the improvements in pain, sexual functioning, sexual distress, body image concerns, pain anxiety, pain catastrophizing, painful intercourse self-efficacy, depressive symptoms and pelvic floor disorder symptoms in gynecological cancer survivors with dyspareunia after PFPT, and to explore women's perceptions of treatment effects at one-year follow-up. METHODS This mixed-method study included 31 gynecological cancer survivors affected by dyspareunia. The women completed a 12-week PFPT treatment comprising education, manual therapy and pelvic floor muscle exercises. Quantitative data were collected using validated questionnaires at baseline, post-treatment and one-year follow-up. As for qualitative data, semi-structured interviews were conducted at one-year follow-up to better understand women's perception and experience of treatment effects. RESULTS Significant improvements were found from baseline to one-year follow-up on all quantitative outcomes (P ≤ 0.028). Moreover, no changes were found from post-treatment to one-year follow-up, supporting that the improvements were sustained at follow-up. Qualitative data highlighted that reduction in pain, improvement in sexual functioning and reduction in urinary symptoms were the most meaningful effects perceived by participants. Women expressed that these effects resulted from positive biological, psychological and social changes attributable to multimodal PFPT. Adherence was also perceived to influence treatment outcomes. CONCLUSIONS Findings suggest that the short-term improvements following multimodal PFPT are sustained and meaningful for gynecological cancer survivors with dyspareunia one year after treatment.
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Affiliation(s)
- Marie-Pierre Cyr
- Faculty of Medicine and Health Sciences, School of Rehabilitation, University of Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Rosalie Dostie
- Faculty of Medicine and Health Sciences, School of Rehabilitation, University of Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Chantal Camden
- Faculty of Medicine and Health Sciences, School of Rehabilitation, University of Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Chantale Dumoulin
- Faculty of Medicine, School of Rehabilitation, University of Montreal, Montreal, Quebec, Canada
- Research Center of the Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
| | - Paul Bessette
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Faculty of Medicine and Health Sciences, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Annick Pina
- Faculty of Medicine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada
- Research Center of the Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - Walter Henry Gotlieb
- Faculty of Medicine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | - Korine Lapointe-Milot
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Faculty of Medicine and Health Sciences, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Marie-Hélène Mayrand
- Research Center of the Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, Departments of Obstetrics and Gynecology and Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Mélanie Morin
- Faculty of Medicine and Health Sciences, School of Rehabilitation, University of Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
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Vargas Maldonado D, Madsen AM. Vaginal symptoms in women who are affected by gynecologic cancer. Curr Opin Obstet Gynecol 2021; 33:474-482. [PMID: 34494971 DOI: 10.1097/gco.0000000000000743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Pelvic floor disorders are common among gynecologic cancer survivors. With improvements in survivorship, quality of life conditions in these women need greater attention and care. This review focuses specifically on vulvovaginal symptoms, which are common and have a negative impact on sexual health and quality of life in women affected by gynecologic cancer. RECENT FINDINGS We review publications on treatment-specific sexual health outcomes, screening and treatment of vulvovaginal symptoms and sexual pain, and surgical management options. Recent evidence regarding the safety of concomitant prolapse repair at the time of surgery for gynecologic malignancies and CO2 laser therapy is discussed and areas needing further research and innovation are highlighted. SUMMARY Pelvic floor disorders, including vaginal and sexual health concerns, are common in women affected by gynecologic cancer due to both common risk factors and as a side effects of cancer treatment. Gynecologists play a critical role in screening, treatment, and collaboration with other specialists to provide comprehensive care for these women throughout their lifetime.
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Affiliation(s)
- Darlene Vargas Maldonado
- Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics & Gynecology, Mayo Clinic, Rochester, Minnesota, USA
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11
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Pattanshetty R, Rao M. Cancer-related fibrosis: Prevention or treatment? – A descriptive review. JOURNAL OF DR. NTR UNIVERSITY OF HEALTH SCIENCES 2021. [DOI: 10.4103/jdrntruhs.jdrntruhs_104_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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