Pelvic floor dysfunction in endometrial cancer patients after treatment. A literature review

Abstract

Endometrial cancer (EC) survivors are increasing progressively. However, treating this disorder may detrimentally affect the pelvic organs, resulting in pelvic floor disorders (PFD): urinary incontinence, pelvic organ prolapse, and bowel dysfunction. The aim of this review is to investigate the prevalence of PFD in EC survivors following both surgical and nonsurgical treatments. The authors conducted a structured search in the following databases: MEDLINE, EMBASE, Global Health, The Cochrane Library, and Web of Science from inception until August 2021. The inclusion criteria were: (1) women with EC, (2) observational studies, (3) original data, (4) PFD result evaluation, and (5) the use of verified tools for the evaluation of PFD. The initial search found 590 articles for PFD and endometrial cancer. Only 10 of the studies were finally available for further analysis, including 1849 individuals with EC. In total, the incidence of UI increased from 7.6% to 20.8% after EC therapy. The incidence of stress and urge UI after treatment ranged from 23 to 74.3% and 20.8 to 71.4%, respectively. The prevalence of POP was as high as 13.6% in 638 EC survivors. The prevalence of fecal incontinence was 21% in 732 EC survivors. In conclusion, PFDs are common after endometrial cancer treatment. The lack of comparative studies between the type of EC and the type of treatment limits further exploration of the differences in PFD frequency among EC survivors and the variety of EC treatments.