Disfunções do assoalho pélvico em sobreviventes ao câncer de colo de útero

Abstract

Cervical cancer (CC) is a public health problem, being the fourth most common cause of cancer and the fourth leading cause of death among women, its treatment includes different modalities, such as surgery and radiotherapy, or radiotherapy/ chemotherapy, depending on the stage. Despite the advances provided by these therapies, such as greater survival and impact on quality of life, there are still anatomophysiological disorders that can affect the pelvic organs, causing pelvic floor dysfunction (PFD) as well as interference with sexual life. In this context, the objective of the study was to analyze the prevalence of PAD and the impact on the quality of life of women who survived cervical cancer. This is an observational study, with a cross-sectional design, developed in a private institution in the interior of Maranhão. The sample consisted of 75 women who underwent CC treatment in the period from 2017 to 2022. Sociodemographic, clinical, gynecological and obstetric questionnaires and instruments validated for Portuguese that assess sexual function (FSFI), the prevalence of symptoms of PAD (PFDI-20), the impact of disorders on specific quality of life (PFIQ-7) and overall quality of life (WHOQOL-bref). For data analysis, the Chi-square test was performed between groups in relation to PAD symptoms, non-parametric Kruskal-Wallis tests with Nemenyi post-hoc for multiple comparisons comparing PAD according to independent variables. Spearman's correlation test (ρ) between the domains of the PFDI-20 and PFQI-7 questionnaires. Data were analyzed with a 95% confidence interval and a 5% significance level. Study was approved by the Ethics and Research in Human Beings Committee according to Protocol n°5,501,210. The sample showed a predominance of women who underwent surgical treatment, low education, mean age of 48.64 years, low socioeconomic status and time to end cancer treatment on average 31.21 months. There was a prevalence of women with PAD symptoms, with urinary symptoms (UDI-6) causing the most discomfort, followed by anorectal symptoms (CRADI-8) according to the PFDI-20. In the evaluation of the sexual function of the sexually active women, they presented sexual dysfunctions (FSFI=14.48±9.96). The presence and discomfort of pelvic floor symptoms have a negative impact on the quality of life assessed by the PFIQ-7, considering daily activities and emotional health (ρ (rho)=0.68; p<0.001). Regarding general quality of life, the domains “Social Relationships” and “Environment” had the greatest negative impact (15.18±2.51 and 14.79±2.43), respectively. It is concluded, therefore, that among the symptoms of PAD in women who have survived CC, there is a prevalence of urinary, anorectal and sexual dysfunctions. In addition, the presence and discomfort of PAD symptoms have a negative impact on specific quality of life.da