Pelvic floor outcomes in patients who have undergone general rehabilitation following surgery for colorectal cancer: A pilot study

ABSTRACT

Background: There is a paucity of evidence on changes in pelvic floor outcomes in patients with colorectal cancer (CRC) following general oncology rehabilitation. Objective: In patients following surgery for CRC, to explore changes in pelvic floor muscle function before and after a general oncology rehabilitation program; and to compare pelvic floor symptoms in patients undergoing the rehabilitation program to a matched control group. Methods: This pilot study was conducted as an observational study nested within a prospective study evaluating the feasibility of a general oncology rehabilitation program for patients following surgery for abdomino-pelvic cancer. In this nested study, pelvic floor muscle function was measured in 10 participants with CRC (rehabilitation group) before and immediately after the 8-week rehabilitation program and at 6-month follow-up. Data of 10 matched participants from the prospective study who completed questionnaires only at the same assessment time points were used as a control group. Symptom measurement tools were the Australian Pelvic Floor Questionnaire (APFQ) and the International Consultation on Incontinence Questionnaire-Bowel module (ICIQ-B). Descriptive statistics were used to summarize data on pelvic floor muscle function of the rehabilitation group, and repeated measures analysis of variance was used to assess within- and between-group changes in pelvic floor symptom scores over time in the rehabilitation group and control group matched for gender and level of tumor. Results: Scores in the bowel domain of the APFQ (p = 0.037) and bowel control domain of the ICIQ-B (p = 0.026) improved in the rehabilitation group only and the improvement in ICIQ-B was sustained at 6-month follow-up. There were no significant differences in bladder and bowel symptoms between the rehabilitation and matched control groups (p > 0.05) at any assessment time-point. Conclusions: Patients undergoing a general rehabilitation program following surgery for CRC demonstrated improved bowel symptoms from pre- to post-rehabilitation program; however, there were no differences when compared with matched controls who did not undertake rehabilitation. Further studies with larger sample sizes and longer-term follow-up are needed confirm these findings.

KEYWORDS:

• Pelvic floor muscle
• digital rectal examination
• manometry
• transperineal ultrasound
• rehabilitation

Acknowledgments

The authors would like to thank the participants, participating surgeons, and the staff from Cabrini Health and the Centre for Allied Health Research and Education at Cabrini Institute for their contribution and assistance to the study. We thank Dr Margaret Sherburn and Ms Angela Khera for their assistance in clinical examination training. The authors also thank A/Prof Graham Hepworth of the Statistical Consulting Centre at the University of Melbourne for his advice on our statistical approach to the analyses. This study was supported by grant funding from the Cabrini Institute, Victoria, Australia.

Declaration of interest

The authors report no declarations of interest.

Additional information

Funding

This study was supported by grant funding from the Cabrini Institute, Victoria, Australia.