Abstract
INTRODUCTION AND OBJECTIVES:
Pelvic floor disorders (PFDs) disproportionately affect women with bladder cancer (BC), yet they are underassessed and undertreated, despite a significant impact on quality of life (QOL). The Survivorship and Pelvic floor InterventioNs (SPIN) study was created for women with BC (newly diagnosed, undergoing treatment, or previously treated) to receive PFD care from a urogynecologist. This study aimed to describe the prevalence and severity of PFDs among women enrolled in SPIN.
METHODS:
Women were recruited to SPIN during urologic oncologist visits. Participants completed validated questionnaires prior to their initial visit, including the Pelvic Floor Distress Inventory (PFDI-20), Female Sexual Function Index (FSFI), Perceived Stress Scale (PSS), and a series of questions assessing the relationship between PFDs and BC treatments. Descriptive statistics summarized patient characteristics and scores. Group comparisons used Wilcoxon rank-sum, with significance set at p<0.05.
RESULTS:
Of 33 women enrolled, 25 completed their baseline surveys (median age 68 years, IQR 63–73; 93.9% White, 54.5% Hispanic). Baseline PFD burden was substantial: UDI-6 scores (subset of PFDI-20 examining urinary bother) had a median score of 41.7 (IQR 25, 45.8) and PFDI-20 score 70.8 (IQR 52.1, 97.9). 54.5% reported overactive bladder (OAB) symptoms and 48.5% stress urinary incontinence (SUI). Women with SUI had higher urinary distress than those without (UDI-6: 41.7 vs 0, p>0.01). Sexual dysfunction was prevalent (80%) with median FSFI 5.0 (IQR 3.6, 19.6). Perceived stress was moderate to high (median PSS 20.5, IQR 18.5–23). 29.2% reported oncologist discussion of sexual health impacts, 41.7% reported discussions of bladder symptom impacts, while 50% of participants reported no discussion of treatment effects.
CONCLUSIONS:
Baseline findings reveal a significant burden of PFDs among women with BC, with 50% of patients reporting these symptoms were not assessed during oncologic visits. This highlights the need for multidisciplinary care to improve QOL and outcomes for female BC patients.