Female pelvic cancer survivors' experiences of pelvic floor muscle training after pelvic radiotherapy.

purposeTo describe experiences of a 3-month pelvic floor muscle training (PFMT) period, with or without support from a physiotherapist, among females with urinary and/or fecal incontinence after pelvic radiotherapy.

methodThis qualitative interview study included eleven women (aged 47-83 years) with urinary and/or fecal incontinence after radiotherapy treatment for pelvic cancer (radiotherapy completed 3-60 months ago). The eleven informants were part of a larger randomized controlled intervention study where they practiced PFMT, with or without support from a physiotherapist, for 3 months. The support from a physiotherapist included individual support with biofeedback as well as group training. The women were interviewed individually soon after the completion of the pelvic floor muscle training period, and data were analyzed with qualitative content analysis.

resultA structured training program, individual support from a physiotherapist, and strategies to establish a daily workout routine were described as valuable when practicing pelvic floor muscle training. Participating in the study gave a sense of meaningfulness and motivation to practice, partly due to the knowledge of a follow-up after the study period. Group and home training were described as both a facilitator and a barrier to PFMT. The women experienced that PFMT had influenced pelvic floor function in terms of increased pelvic floor strength, reduced urinary and fecal incontinence, and an increased ability to hold urine and feces during urgency. PFMT had a relieving effect on pelvic floor pain, although it also contributed to some increase in pain. The perceived improvement in pelvic muscle function led to decreased anxiety, increased safety, feelings of greater freedom in everyday life, a changed attitude toward physical activity, and improved sexual health. All women expressed an intention to continue practicing PFMT and a desire for information and opportunities for PFMT, under the guidance of a physiotherapist, to be implemented in conventional pelvic cancer rehabilitation and made available to all women after pelvic cancer treatment.

conclusionThe women who live with the experience of pelvic cancer experienced PFMT as a meaningful intervention for managing urinary and/or fecal incontinence after pelvic radiotherapy. They considered that information and support from a physiotherapist are essential in pelvic cancer rehabilitation, such as PFMT, and should be offered to all women after pelvic cancer treatment.