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 Jan 25;17(1):e0262844. doi: 10.1371/journal.pone.0262844. eCollection 2022.

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.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cancer Survivors / psychology*
  • Dyspareunia* / etiology
  • Dyspareunia* / physiopathology
  • Dyspareunia* / psychology
  • Dyspareunia* / therapy
  • Exercise Therapy*
  • Female
  • Follow-Up Studies
  • Genital Neoplasms, Female* / physiopathology
  • Genital Neoplasms, Female* / psychology
  • Genital Neoplasms, Female* / therapy
  • Humans
  • Middle Aged
  • Pelvic Floor
  • Pelvic Floor Disorders* / etiology
  • Pelvic Floor Disorders* / physiopathology
  • Pelvic Floor Disorders* / psychology
  • Pelvic Floor Disorders* / therapy

Grants and funding

The Quebec Network for Research on Aging funded the current study. The Fonds de recherche du Québec – Santé granted a scholarship to Marie-Pierre Cyr and salary awards to Mélanie Morin, Chantal Camden and Marie-Hélène Mayrand. The Canadian Research Chair Tier II on Urogynecological Health and Aging supported Chantale Dumoulin. The laboratory infrastructures were funded by the Canadian Foundation for Innovation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.