The aim of the Roundtable topic is to consider the effects of surgery and radiotherapy on pelvic floor structure and function in men after prostate cancer and in women after gynaecological cancer treatments.

Learning Objectives:

• To provide registrants with a greater understanding of the specific impacts of prostate cancer treatments on pelvic floor function and implications for post-treatment conservative therapies to address pelvic floor dysfunction, particularly urinary incontinence
• To provide registrants with a greater understanding of the specific impacts of gynaecological cancer treatments on pelvic floor function, how these may vary by tumour and treatment type, and implications for post-treatment conservative therapies to address pelvic floor dysfunction
• To provide registrants with a greater understanding of the specific impacts of prostate cancer treatments on pelvic floor muscle function and implications for pre-/post-treatment pelvic floor muscle therapies to address pelvic floor dysfunction, particularly urinary incontinence; evidence to support these therapies; compare and contrast with pelvic floor muscle therapies to treat post-gynaecological cancer pelvic floor dysfunction
• To provide registrants with a greater understanding of the specific impacts of gynaecological cancer treatments on pelvic floor muscle function and implications for pre-/post-treatment pelvic floor muscle therapies to address pelvic floor dysfunction; evidence to support these therapies; compare and contrast with pelvic floor muscle therapies to treat post-prostate cancer pelvic floor dysfunction.

The take home message is for registrants to appreciate the differences and similarities between prostate and gynaecological cancer treatments and their impacts on bladder, bowel and sexual dysfunction and pelvic floor muscle function. These treatments have implications for post cancer treatment rehabilitation of pelvic floor dysfunction. Evidence is emerging to guide rehabilitation to provide the most effective treatment for sufferers.

Pre-reading from Paul Hodges:

• Hodges PW, Stafford RE, Hall L, Neumann P, Morrison S, Frawley H, Doorbar-Baptist S, Nahon I, Crow J, Thompson J, Cameron AP. Reconsideration of pelvic floor muscle training to prevent and treat incontinence after radical prostatectomy. Urol Oncol. 2020 May;38(5):354-371. doi: 10.1016/j.urolonc.2019.12.007. Epub 2019 Dec 25. PMID: 31882228.

Pre-reading from Melanie Morin:

• Arthur, E.K., Wills, C.E., & Menon, U. (2018). A systematic review of interventions for sexual well-being in women with gynecologic, anal, or rectal cancer. Oncology Nursing Forum, 45(4), 469-482. doi:http://dx.doi.org/10.1188/18.ONF.469-482.
• Bernard, S., Ouellet, M. P., Moffet, H., Roy, J. S., & Dumoulin, C. (2016). Effects of radiation therapy on the structure and function of the pelvic floor muscles of patients with cancer in the pelvic area: a systematic review. Journal of Cancer Survivorship, 10(2), 351-362.
• Brennen R, Lin KY, Denehy L, Frawley HC. The effect of pelvic floor muscle interventions on pelvic floor dysfunction after gynecological cancer treatment: a systematic review. Physical Therapy. 2020;100(8):1357-71.
• Cyr MP, Dumoulin C, Bessette P, Pina A, Gotlieb WH, Lapointe-Milot K, Morin M. Feasibility, acceptability and effects of multimodal pelvic floor physical therapy for gynaecological cancer survivors suffering from painful sexual intercourse: A multicenter prospective interventional study. Gynecol Oncol. 2020.
• Cyr MP, Dumoulin C, Bessette P, Pina A, Gotlieb WH, Lapointe-Milot K, Morin M. Characterizing pelvic floor muscle function and morphometry in gynaecological cancer survivors with dyspareunia: A comparative cross-sectional study. Phys Ther. 2020. Accepted.
• Frawley, HC, Brennen, R 2021. Chapter 13: Gynaecological cancer and pelvic floor dysfunction In Bø, K, Berghmans, B, Mørkved, S, Van Kampen, M (Eds) Evidence-Based Physical Therapy for the Pelvic Floor 3rd Edition. Oxford: Elsevier.
• Rutledge TL, Heckman SR, Qualls C, Muller CY, Rogers RG. Pelvic floor disorders and sexual function in gynecologic cancer survivors: a cohort study. Am J Obstet Gynecol. 2010 Nov;203(5):514.e1-7. doi: 10.1016/j.ajog.2010.08.004.
• Yang EJ, Lim JY, Rah UW, Kim YB. Effect of a pelvic floor muscle training program on gynecologic cancer survivors with pelvic floor dysfunction: a randomized controlled trial. Gynecol Oncol. 2012 Jun;125(3):705-11.