Telerehabilitation reduced urinary incontinence, pelvic pain and dyspareunia in women after treatment for gynaecological cancer: a randomised trial.

Abstract

QUESTION: How effective is a telerehabilitation program in reducing reports of pelvic floor dysfunction in women after gynaecological cancer treatment? DESIGN: Randomised controlled trial with blinded assessors, concealed allocation and intention-to-treat analysis. PARTICIPANTS: Fifty-eight women reporting urinary incontinence (UI) after treatment for gynaecological cancer. INTERVENTIONS: Experimental group participants were allocated to undertake telerehabilitation sessions including pelvic floor muscle training once a week for 12 weeks. The control group received usual care. OUTCOME MEASURES: The primary outcome was the prevalence of UI on the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI-SF). The secondary outcomes were: the impact of UI on quality of life (ICIQ-UI-SF), sexual function (Female Sexual Function Index), dyspareunia (numerical assessment scale), self-esteem (Rosenberg), pain (numerical assessment scale), faecal incontinence, stool consistency, vaginal stenosis, quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire) and level of physical activity. After 12 weeks, the telerehab group also responded about treatment satisfaction, adherence and system usability. RESULTS: After 12 weeks, the experimental group had better outcomes than the control group in several areas: prevalence of UI (RD -0.45, 95% CI -0.62 to -0.23); total ICIQ-UI-SF score (MD -9.5, 95% CI -11.8 to -7.1); pelvic pain (MD -3.1, 95% CI -4.7 to -1.4); self-esteem (MD 2.9, 95% CI 0.7 to 5.1); and measures of vaginal stenosis and quality of life. CONCLUSION: A 12-week telerehabilitation program was effective in reducing reports of UI, severity of UI, pelvic pain and dyspareunia in women after the treatment of gynaecological cancer. REGISTRATION: Brazilian Clinical Trials Registry (ReBEC) RBR-8ht5nqq.