Ramaseshan Aparna S, Felton Jessica, Roque Dana, Rao Gautam, Shipper Andrea G, Sanses Tatiana V D
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, 22 S. Greene St., Baltimore, MD, USA.
Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
Int Urogynecol J. 2018 Apr;29(4):459-476. doi: 10.1007/s00192-017-3467-4. Epub 2017 Sep 19.
Pelvic floor disorders (PFDs) negatively affect quality of life in the general population, and their prevalence in gynecologic cancer survivors has not been systematically described. This study aimed to determine the prevalence of PFDs in cancer survivors. We hypothesized that the prevalence of PFDs in the gynecologic cancer population would be higher than in the general female population.
We searched PubMed (1809 to present), EMBASE (1974 to present), and the Cochrane Central Register of Controlled Trials (CENTRAL) through May 2017. The search combined subject headings, title, and abstract words for gynecologic cancer, PFDs, and prevalence. Any studies evaluating the prevalence of PFDs in gynecologic malignancies were included.
A total of 550 articles met the designated search criteria and 31 articles were included in this review. In cervical cancer survivors, before treatment the prevalences of stress urinary incontinence (SUI), urgency urinary incontinence (UUI) and fecal incontinence (FI) were 24-29%, 8-18% and 6%, respectively, and after treatment the prevalences of SUI, UUI, urinary retention, FI, fecal urge, dyspareunia and vaginal dryness were 4-76%, 4-59%, 0.4-39%, 2-34%, 3-49%, 12-58% and 15-47%, respectively. In uterine cancer survivors, before treatment the prevalences of SUI, UUI and FI were 29-36%, 15-25% and 3%, respectively, and after treatment the prevalences of urinary incontinence (UI) and dyspareunia were 2-44% and 7-39%, respectively. In vulvar cancer survivors, after treatment the prevalences of UI, SUI and FI were 4-32%, 6-20% and 1-20%, respectively. In ovarian cancer survivors, the prevalences of SUI, UUI, prolapse and sexual dysfunction were 32-42%, 15-39%, 17% and 62-75%, respectively.
PFDs are prevalent in gynecologic cancer survivors and this is an important area of clinical concern and future research.
盆底功能障碍（PFDs）对普通人群的生活质量有负面影响，且其在妇科癌症幸存者中的患病率尚未得到系统描述。本研究旨在确定癌症幸存者中PFDs的患病率。我们假设妇科癌症人群中PFDs的患病率高于普通女性人群。
我们检索了截至2017年5月的PubMed（1809年至今）、EMBASE（1974年至今）和Cochrane对照试验中心注册库（CENTRAL）。检索结合了妇科癌症、PFDs和患病率的主题词、标题和摘要词。纳入任何评估妇科恶性肿瘤中PFDs患病率的研究。
共有550篇文章符合指定的检索标准，31篇文章纳入本综述。在宫颈癌幸存者中，治疗前压力性尿失禁（SUI）、急迫性尿失禁（UUI）和粪失禁（FI）的患病率分别为24 - 29%、8 - 18%和6%，治疗后SUI、UUI、尿潴留、FI、便急、性交困难和阴道干燥的患病率分别为4 - 76%、4 - 59%、0.4 - 39%、2 - 34%、3 - 49%、12 - 58%和15 - 47%。在子宫癌幸存者中，治疗前SUI、UUI和FI的患病率分别为29 - 36%、15 - 25%和3%，治疗后尿失禁（UI）和性交困难的患病率分别为2 - 44%和7 - 39%。在外阴癌幸存者中，治疗后UI、SUI和FI的患病率分别为4 - 32%、6 - 20%和1 - 20%。在卵巢癌幸存者中，SUI、UUI、脱垂和性功能障碍的患病率分别为32 - 42%、15 - 39%、17%和62 - 75%。
PFDs在妇科癌症幸存者中很普遍，这是临床关注和未来研究的一个重要领域。
