Bernard Stéphanie, Moffet Hélène, Plante Marie, Ouellet Marie-Pier, Leblond Jean, Dumoulin Chantale
Phys Ther. 2017 Apr 1;97(4):438-448. doi: 10.1093/ptj/pzx012.
Endometrial cancer is the fourth most prevalent cancer in Canadian women. Radiotherapy (RT) is frequently recommended as an adjuvant treatment. There is a high prevalence (>80%) of urinary incontinence (UI) after RT. It is plausible that UI is associated, at least in part, with alterations of the pelvic-floor muscles (PFM).
The aim of this exploratory study was to compare the PFM functional properties of women reporting UI after hysterectomy and RT for endometrial cancer with those of women with a history of hysterectomy but without UI.
A descriptive cross-sectional study was conducted. Eleven women were recruited for the affected group, and 18 were recruited for the comparison group.
Urogenital and bowel functions were assessed using International Consultation on Incontinence Questionnaires, and PFM properties were evaluated using a Montreal dynamometer. Nonparametric tests were used for comparison of personal characteristics, functional status, and muscle properties. A correspondence analysis detailed the association between UI severity and PFM properties.
Maximal opening of dynamometer branches, maximal vaginal length, PFM maximum force and rate of force development in a strength test, and number of rapid contractions during a speed test were reduced in the affected group. No significant difference was found for the endurance test. The severity of UI was found to correspond to the rate of force development and the number of rapid contractions in a speed test, endurance, age, and vaginal length.
The results are limited to the population studied. The small sample size limited the strength of the conclusions.
Some evidence of alterations in PFM properties were found in women with UI after hysterectomy and RT for endometrial cancer. These alterations appeared to be associated with UI, suggesting a possible role for rehabilitation.
子宫内膜癌是加拿大女性中第四大常见癌症。放射治疗（RT）常被推荐作为辅助治疗方法。放疗后尿失禁（UI）的患病率很高（>80%）。尿失禁至少部分与盆底肌肉（PFM）的改变有关，这似乎是合理的。
本探索性研究的目的是比较因子宫内膜癌接受子宫切除术后放疗且出现尿失禁的女性与有子宫切除史但无尿失禁的女性的盆底肌肉功能特性。
进行了一项描述性横断面研究。受影响组招募了11名女性，对照组招募了18名女性。
使用国际尿失禁咨询问卷评估泌尿生殖和肠道功能，使用蒙特利尔测力计评估盆底肌肉特性。采用非参数检验比较个人特征、功能状态和肌肉特性。对应分析详细阐述了尿失禁严重程度与盆底肌肉特性之间的关联。
受影响组测力计分支的最大张开度、最大阴道长度、力量测试中盆底肌肉的最大力量和力量发展速率以及速度测试中的快速收缩次数均降低。耐力测试未发现显著差异。发现尿失禁的严重程度与速度测试中的力量发展速率、快速收缩次数、耐力、年龄和阴道长度相对应。
结果仅限于所研究的人群。样本量小限制了结论的说服力。
在因子宫内膜癌接受子宫切除术后放疗且出现尿失禁的女性中发现了一些盆底肌肉特性改变的证据。这些改变似乎与尿失禁有关，提示康复可能发挥作用。
