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Review
. 2023 Dec 10;15(12):e50287.
doi: 10.7759/cureus.50287. eCollection 2023 Dec.

Efficacy of Pelvic Floor Muscle Training for Postoperative Patients With Rectal Cancer: A Systematic Review and Meta-Analysis

Yuki Nakashima  1   2 , Kenichi Fudeyasu  1 , Yuki Kataoka  2   3   4   5 , Shunsuke Taito  1   2 , Takashi Ariie  2   6 , Yukio Mikami  7
Affiliations
Review

Efficacy of Pelvic Floor Muscle Training for Postoperative Patients With Rectal Cancer: A Systematic Review and Meta-Analysis

Yuki Nakashima et al. Cureus. .

Abstract

This study aimed to assess the effectiveness of pelvic floor muscle training (PFMT) for fecal incontinence (FI) and health-related quality of life (HR-QOL) after colorectal cancer surgery. This systematic review (SR) and meta-analysis included randomized controlled trials (RCTs) that examined the effects of PFMT after colorectal cancer surgery, which were extracted from several databases in January 2023. The primary outcomes were FI (Wexner scores), HR-QOL, and adverse events. We used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence (CoE). A total of seven RCTs were included. Our SR results suggested that PFMT showed little to no difference in FI (mean difference 0.62 higher; 95% CI: -1.26 to 2.5, low CoE) and adverse events (risk ratio 5.78; 95% CI: 0.28-117.22, low CoE). Two adverse events occurred in the PFMT group (anastomotic stenosis, suboptimal use of laxatives) and were not observed in controls. HR-QOL was measured in two RCTs using 12-item Short Form Survey (SF-12) and fecal incontinence quality of life (FIQL). Two RCTs found no trend toward a positive impact on HR-QOL. Higher quality RCTs on colorectal cancer after surgery are required. Furthermore, extending the duration of the PFMT intervention may be necessary to ensure its success.

Keywords: colorectal cancer; fecal incontinence; pelvic floor muscle training; rectal cancer; rehabilitation.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA flow diagram of the literature search results.
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2
Figure 2. Risk of bias summary: (A) FI, (B) HR-QOL, (C) adverse events, and (D) bowel dysfunction after surgery.
FI: fecal incontinence; HR-QOL: health-related quality of life.
Figure 3
Figure 3. Forest plot of comparison: (A) FI, (B) HR-QOL, (C) adverse events, and (D) bowel dysfunction after surgery
FI: fecal incontinence; HR-QOL: health-related quality of life.
See this image and copyright information in PMC

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