Vaginal Dilator and Pelvic Floor Exercises for Vaginal Stenosis, Sexual Health and Quality of Life among Cervical Cancer Patients Treated with Radiation: Clinical Report

Araya-Castro, Paulina; Sacomori, Cinara; Diaz-Guerrero, Paulette; Gayan, Patricio; Román, Devora; Sperandio, Fabiana Flores

doi:10.1080/0092623x.2020.1760981

Cited by 15 publications

(11 citation statements)

References 31 publications

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“…In the current study, it was revealed that radiotherapy was an important independent risk factor for postoperative sexual dysfunction (OR: 5.000, 95% CI: 1.879–13.30, p < 0.01), which was consistent with the previously reported finding 17–19 . Pelvic floor muscle exercises (PFME), vaginal lubrication, and vaginal dilation can assist patients to improve their sexual function 20–22 …”

Section: Discussionsupporting

confidence: 90%

“…[17][18][19] Pelvic floor muscle exercises (PFME), vaginal lubrication, and vaginal dilation can assist patients to improve their sexual function. [20][21][22] Sexual dysfunction is a common clinical challenge among CC survivors in China, and a great number of patients strongly desire to obtain further information on how to manage sexual problems, while no adequate attention has been paid to sexual function on behalf of healthcare providers, impairing the diagnosis and treatment of sexual disorders. 8,23,24 In China, only a small proportion of cervical cancer patients receive HRT after medically induced menopause caused by ovariectomy, the present study's confirmation of HRT's effectiveness has important clinical implications for healthcare providers.…”

Section: Discussionmentioning

confidence: 99%

“…17 , 18 , 19 Pelvic floor muscle exercises (PFME), vaginal lubrication, and vaginal dilation can assist patients to improve their sexual function. 20 , 21 , 22 …”

Section: Discussionmentioning

confidence: 99%

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Assessment of long‐term sexual function of cervical cancer survivors after treatment: A cross‐sectional study

Wang

Zhuang

et al. 2022

J of Obstet and Gynaecol

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Objectives: This study aimed to investigate the long-term sexual function of patients with cervical cancer who underwent treatment and to explore influential factors. Methods: This retrospective cross-sectional study was conducted at Peking University First Hospital in (Beijing, China). A total of 207 patients, who were diagnosed with Stage IA-IIA cervical cancer and had undergone surgical treatment (some patients had also been treated with adjuvant radiotherapy and chemotherapy) between January 2010 and August 2020, completed questionnaires via telephone. The median time since diagnosis was 54 (range, 13-138) months. Sexual function was assessed using the validated short form of Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). The multivariate logistic regression analysis was performed to determine factors influencing sexual function after treatment. Results: The mean preoperative PISQ-12 score was 39.42 AE 3.922, and the mean postoperative PISQ-12 score was 32.60 AE 6.592, indicating a significant decrease in postoperative PISQ-12 score compared with preoperation (p < 0.001). In total, 49.8% of the patients had sexual dysfunction after treatment. According to the results of the multivariate logistic regression analysis, longer follow-up (months), ovariectomy, lack of hormone replacement therapy after ovariectomy and adjuvant radiotherapy were significantly associated with sexual dysfunction after treatment (p < 0.05). There was no significant correlation among surgical method, tumor stage, adjuvant chemotherapy, and sexual dysfunction after treatment. Conclusions: The sexual function of cervical cancer survivors significantly decreased after treatment, which was related to the length of follow-up, ovariectomy, and adjuvant radiotherapy. Hormone replacement therapy after ovariectomy can help patients to improve their sexual function.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Assessment of long‐term sexual function of cervical cancer survivors after treatment: A cross‐sectional study

Wang

Zhuang

et al. 2022

J of Obstet and Gynaecol

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“…The third session was 3 months after the second and included only reinforcement. This protocol has previously been published [ 32 , 33 ].…”

Section: Methodsmentioning

confidence: 99%

Barriers to and facilitators of adherence to pelvic floor muscle exercises and vaginal dilator use among gynecologic cancer patients: a qualitative study

Araya-Castro

Roa-Alcaino

Celedón

et al. 2022

Support Care Cancer

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Objective Women with gynecologic cancer may suffer from pelvic floor dysfunction (PFD). Before radiotherapy, prehabilitation with pelvic floor muscle exercises (PFME) and vaginal dilator (VD) might prevent it and foster sexual life. This study aims to explore the experience of gynecologic cancer patients getting external beam radiation treatments regarding barriers to and facilitators of adherence to a prehabilitation program to prevent PFD. Methods This qualitative research with thematic content analysis included 11 women with gynecologic cancer and different levels of adherence to PFME and VD. Participants were interviewed based on a semi-structured script. The information was analyzed manually, assisted with Nvivo12® software, and triangulated with open coding. Results High self-motivation, desire to improve their health, symptoms of improvement, availability of time, the desire to resume sexual life, and the support of the partner were facilitators of adherence. The instructional exercise audio, clarity of the information, and closer communication with the physical therapist were also valued. The main barriers were general malaise secondary to oncological treatments, forgetfulness, lack of time, misinformation, lack of coordination with the treatment team, discomfort with the VD, and a feeling of shame. Feedback from the attending physician was a facilitator when present or a barrier when absent. Conclusion These barriers and facilitators should be considered when designing and implementing preventive programs with PFME and VD. Behavioral counselling should consider the desire to remain sexually active; in such cases, including the partner in the therapeutic process is appraised. Otherwise, the focus should be on benefits for maintenance of pelvic floor function.

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“…40 However, more patient reported outcome data are required to better understand the problem and investigate options for prevention and treatment. 41,42 Currently management mainly takes the form of pre and post-treatment sexual health counselling, 43 pelvic floor physiotherapy, and vaginal dilators in women, 44,45 and sexual aids such as phosphodiesterase 5 inhibitors in men, to improve sexual function. 46 Ideally counselling and interventions should be undertaken at a dedicated multi-disciplinary sexual health clinic, 43 including specifically trained oncology nurses providing psychological and practical support.…”

Section: Managementmentioning

confidence: 99%

Pelvic Radiation Disease

Sammour

Kahokehr

2022

Clin Colon Rectal Surg

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Pelvic radiation is increasingly being used for the neoadjuvant and definitive treatment of pelvic organ malignancy. While this treatment can be highly effective, and may assist in organ sparing, it is also associated with significant toxicity and devastating adverse events that need to be considered. In broad terms, pelvic radiation disease affects both the primary target organ as well as adjacent organs and soft tissue structures, with complications that can be classified and graded according to consensus criteria. The complication grade is often modality, dose, and area dependent. The most common manifestations are proctitis, cystitis, recto-urethral fistula, ureteric stricture, and bone involvement. Toxicity can be misdiagnosed for many years, resulting in significant management delays. Complications can be difficult to prevent and challenging to treat, requiring specialized multi-disciplinary input to achieve the best possible strategy to minimize impact and improve patient quality of life.

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Vaginal Dilator and Pelvic Floor Exercises for Vaginal Stenosis, Sexual Health and Quality of Life among Cervical Cancer Patients Treated with Radiation: Clinical Report

Cited by 15 publications

References 31 publications

Assessment of long‐term sexual function of cervical cancer survivors after treatment: A cross‐sectional study

Assessment of long‐term sexual function of cervical cancer survivors after treatment: A cross‐sectional study

Barriers to and facilitators of adherence to pelvic floor muscle exercises and vaginal dilator use among gynecologic cancer patients: a qualitative study

Pelvic Radiation Disease

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