Abstract
INTRODUCTION AND OBJECTIVES:
Women with bladder cancer (BC) often experience pelvic floor disorders (PFDs) that are overshadowed by their cancer treatment priorities, however they can severely impact patient 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 assesses if participants demonstrate improvement in PFDs symptoms between baseline and three-month follow-up by participating in SPIN.
METHODS:
Women with BC were recruited during their 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 participant characteristics and questionnaire scores. Paired Wilcoxon signed-rank compared baseline and 3-month results, with significance defined as p<0.05.
RESULTS:
13 women completed both baseline and 3-month assessments. At baseline, participants demonstrated significant symptom burden with a median UDI-6 (subset of PFDI-20 examining urinary bother) score of 37.5 (IQR 29.2, 45.8), PFDI-20 score of 81.3 (IQR 66.7, 103.1), FSFI score of 5.0 (IQR 4.2, 25.5), and PSS of 18 (IQR 11, 21). After three months, urinary distress decreased substantially (UDI-6 20.8, IQR 0, 37.5; p=0.0137), overall pelvic floor distress improved (PFDI-20 37.5, IQR 18.8, 87.5; p=0.0105), and sexual function increased (FSFI 13.4, IQR 5.2, 29.6; p=0.0034). Perceived stress decreased from baseline to 3-months [PSS 10 (6.5, 15), p=0.0020].
CONCLUSIONS:
Enrollment of women with BC in a structured urogynecologic program addressing PFDs (SPIN) significantly improves PFD symptom bother. We propose that all women with BC be offered automatic referral to urogynecologic care to help improve PFD symptom burden and QOL.