Evidence map›Paper›PMID 41579191›Full record

SynthesisInternational urogynecology journal2026

Pelvic Floor Dysfunction Following Gynecologic Cancer Surgery and Adjuvant Therapy: Epidemiology, Mechanisms, and Management-A Systematic Review.

Duygu Kurtuluş, Kevser Arkan, Ferhat Yakup Suçeken, Sedat Akgöl, Behzat Can, Mustafa Behram

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International urogynecology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Duygu KurtuluşDepartment of Physical Medicine and Rehabilitation, Faculty of Medicine, Üsküdar University, Istanbul, Türkiye. dygkurtulus@gmail.com.ORCID http://orcid.org/0000-0002-9763-5912
Kevser ArkanDepartment of Gynecologic Oncology, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye.
Ferhat Yakup SuçekenDepartment of Urology, University of Health Sciences, Ümraniye Training and Research Hospital, Istanbul, Türkiye.
Sedat AkgölDepartment of Gynecologic Oncology, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye.
Behzat CanDepartment of Gynecologic Oncology, Private Bower Hospital, Diyarbakır, Türkiye.
Mustafa BehramDepartment of Obstetrics and Gynecology, Faculty of Medicine, Okan University, Istanbul, Türkiye.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction and hypothesisThis systematic review synthesizes current evidence on the prevalence, risk factors, pathophysiology, clinical manifestations, and management of pelvic floor disorders (PFD) following gynecologic cancer surgery and adjuvant therapy, with an emphasis on rehabilitation, multidisciplinary care, and quality of life.

methodsFollowing PRISMA 2020 guidelines, PubMed, Embase, Scopus, and Web of Science were searched for English-language studies published between January 2000 and May 2025. Eligible studies included adult women with gynecologic malignancies reporting outcomes related to urinary or fecal incontinence, pelvic organ prolapse, chronic pelvic pain, or sexual dysfunction. Data were extracted using a standardized form, qualitatively synthesized, and the risk of bias was assessed using the Newcastle-Ottawa Scale.

resultsThirty studies met the inclusion criteria. PFD were highly prevalent, particularly after radical surgery and adjuvant therapies. Stress urinary incontinence and prolapse were more frequent after radical surgery, while urgency incontinence, vaginal stenosis, and chronic pelvic pain were linked to radiotherapy. Chemotherapy was associated with neurogenic bladder and bowel dysfunction. Independent risk factors included advanced age, obesity, and postmenopausal status. PFD significantly impaired physical, psychological, sexual, and social quality of life. Nerve-sparing and minimally invasive techniques showed promise in reducing dysfunction. Conservative measures-pelvic floor muscle training, biofeedback, vaginal dilators, and lifestyle modification-were effective for many patients, while surgical procedures such as slings and sacrocolpopexy were reserved for severe cases. Emerging options include local estrogen or DHEA after radiotherapy and onabotulinumtoxinA for refractory urge incontinence.

conclusionsPFD are underrecognized yet common and disabling complications in women treated for gynecologic cancers. Multidisciplinary management integrating pelvic floor rehabilitation and individualized survivorship care is essential to improve outcomes and quality of life. Further research should establish standardized screening, preventive strategies, and evidence-based rehabilitation protocols for this high-risk population.

Indexed as

Genital Neoplasms, FemaleGynecologic Surgical ProceduresPelvic Floor DisordersPostoperative ComplicationsFemaleHumansPrevalenceQuality of LifeRadiotherapy, AdjuvantRisk FactorsSexual Dysfunction, PhysiologicalGynecologic oncologyNerve-sparing surgeryPelvic floor disordersPelvic floor rehabilitationPelvic organ prolapseQuality of lifeUrinary incontinence

Identifiers

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.