Physical Therapy Graduate Program, Santa Catarina State University (UDESC), Florianópolis, Brazil.
Center for Assistance, Education and Research in Women's Health (NuSIM), Santa Catarina State University (UDESC), Florianópolis, Brazil.
Support Care Cancer. 2024 Nov 30;32(12):839. doi: 10.1007/s00520-024-09053-6.
To evaluate the effect of a physical therapy program on vaginal length and diameter, pelvic floor strength, and quality of life among gynecological cancer survivors suffering from late-effect vaginal stenosis.
Thirty-four women who were previously diagnosed with gynecological cancer and experiencing vaginal stenosis, at least 12 months post-oncological treatment, were enrolled. The intervention program consisted of ten weeks of individualized weekly sessions, each lasting 50 min, involving perineal massage, progressive vaginal dilation, and pelvic floor exercises. Pre- and post-treatment evaluations included assessments of pelvic floor muscle strength through digital palpation, measurements of vaginal length and diameter using a silicone vaginal dilator, and classification of stenosis according to the Common Terminology Criteria for Adverse Events (CTCAE v5.0). Health-related quality of life was assessed using the FACT-G and FACT-Cx questionnaires.
Twenty-one women completed the physical therapy program. There was a significant increase in vaginal length (p < 0.001), vaginal diameter (p < 0.001) and improvement in pelvic floor muscle strength (p < 0.001), with a large effect size (r = 0.81), a medium effect size (r = -0.77) and a medium effect size (r = -0.78), respectively. This resulted in resolution of vaginal stenosis in 14 participants (66.7%) following intervention. Mean scores for FACT-Cx and FACIT-G, encompassing total scores and physical, social, and functional well-being domains, increased significantly after the treatment.
The proposed physical therapy program demonstrated positive effects on vaginal stenosis, pelvic floor muscle strength and health-related quality of life in gynecological cancer survivors.
评估物理治疗方案对患有晚期阴道狭窄的妇科癌症幸存者的阴道长度和直径、盆底力量和生活质量的影响。
共纳入 34 名患有妇科癌症且至少在肿瘤治疗后 12 个月后出现阴道狭窄的女性。干预方案包括 10 周的个体化每周治疗，每次持续 50 分钟，包括会阴按摩、渐进式阴道扩张和盆底运动。治疗前后评估包括使用数字触诊评估盆底肌肉力量、使用硅酮阴道扩张器测量阴道长度和直径、以及根据常见不良事件术语标准（CTCAE v5.0）对狭窄进行分类。使用 FACT-G 和 FACT-Cx 问卷评估健康相关生活质量。
21 名女性完成了物理治疗方案。阴道长度（p<0.001）、阴道直径（p<0.001）显著增加，盆底肌肉力量明显改善（p<0.001），具有大效应量（r=0.81）、中效应量（r=-0.77）和中效应量（r=-0.78）。治疗后，14 名参与者（66.7%）的阴道狭窄得到缓解。治疗后 FACT-Cx 和 FACIT-G 的总分以及身体、社会和功能健康领域的平均分均显著增加。
该物理治疗方案对妇科癌症幸存者的阴道狭窄、盆底肌肉力量和生活质量有积极影响。
