Department of Gynaecology, Obstetrics, and Reproductive Medicine, University Hospital of Caen, France.
Department of Obstetrics and Gynecology, Rennes Hospital, France.
Gynecol Oncol. 2021 Apr;161(1):264-274. doi: 10.1016/j.ygyno.2021.01.026. Epub 2021 Jan 27.
Pelvic floor disorders (PFD) are common conditions impacting quality of life and sexuality may worsen after ovarian cancer therapies. Our objective was to describe the prevalence of PFD and sexuality in women with ovarian cancer (OC).
We reviewed articles indexed in the MEDLINE database until June 2020 and selected articles assessing UI, POP, FI and sexual dysfunction in a population of women with OC.
Of 360 articles, 18 were included: four assessed UI, two assessed POP, three FI, and 13 sexual dysfunction. PFD findings were highly heterogeneous due to the definitions used and the populations studied. The prevalence of any type of UI in patients with OC before treatment is around 50%, and about 17% report feeling a bulge in their vagina. These rates are similar to those reported in women without cancer. Similarly, the main post-treatment UI scores were not significantly different from women without cancer. Fecal incontinence has been less studied in women with OC but reported as affecting 4% of patients preoperatively and 16% postoperatively. About half of the women are sexually active after surgical treatment with high reported rates of dyspareunia (40-80%) and vaginal dryness (60-80%). Compared with healthy women, some authors found that OC patients had greater problems with loss of desire and poorer sexual function scores; other authors did not find a significant difference.
While PFD seem to be common in women after treatment for OC, the rates are not higher than in the general population. Overall, there is a higher prevalence of UI and sexual dysfunction compared with bowel dysfunction. More prospective studies are needed to explore the impact of gynecologic cancers and their treatments on pelvic floor function and pelvic health-related quality of life.
盆腔器官脱垂（PFD）是常见的影响生活质量的疾病，可能在卵巢癌治疗后恶化。我们的目的是描述卵巢癌（OC）女性中 PFD 和性功能障碍的发生率。
我们检索了 MEDLINE 数据库中截至 2020 年 6 月的文章，并选择了评估 OC 女性尿失禁（UI）、盆腔器官脱垂（POP）、FI 和性功能障碍的文章。
共 360 篇文章，其中 18 篇被纳入：4 篇评估 UI，2 篇评估 POP，3 篇 FI，13 篇性功能障碍。由于使用的定义和研究的人群不同，PFD 发现结果存在高度异质性。在治疗前，OC 患者任何类型 UI 的发生率约为 50%，约 17%的患者报告阴道有肿块感。这些比率与无癌症的女性相似。同样，主要的术后 UI 评分与无癌症的女性没有显著差异。OC 患者的粪便失禁研究较少，但术前报道发病率为 4%，术后为 16%。约一半的女性在手术治疗后仍有性生活，报告性交痛（40-80%）和阴道干燥（60-80%）的比例较高。与健康女性相比，一些作者发现 OC 患者的性欲丧失和性功能评分较差的问题更为严重；其他作者则未发现显著差异。
虽然 PFD 在 OC 治疗后女性中较为常见，但发生率并不高于一般人群。总的来说，与肠道功能障碍相比，UI 和性功能障碍的发生率更高。需要更多的前瞻性研究来探讨妇科癌症及其治疗对盆底功能和与盆腔健康相关的生活质量的影响。
