ArticleFrontiers in oncology2026
Ultrasound-derived pelvic floor parameters and their association with functional impairment in gynecologic cancer survivors: a retrospective cohort study.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Gynecologic cancer survivors often experience pelvic floor dysfunction (PFD). PFD is a common but underdiagnosed complication, likely as a result of structural and/or functional changes caused by treatments for their gynecologic cancers. Objective imaging assessments of pelvic floor integrity in this population are limited. Methods: This exploratory retrospective cohort study evaluated associations between pelvic floor ultrasonography parameters and patient-reported functional impairment in 150 survivors of cervical, endometrial, and ovarian cancer stratified by treatment modality. Pelvic floor muscle (PFM) thickness, mobility, and pelvic organ descent were assessed using standardized ultrasonography protocols. The validated Pelvic Floor Distress Inventory-20 (PFDI-20) was used to assess pelvic floor symptom burden and patient-reported functional impairment. Correlation and multivariable regression analyses were performed after adjustment for relevant clinical covariates. Receiver operating characteristic analysis evaluated the discriminatory capability of ultrasound-derived parameters. Results: Exposure to radiotherapy was associated with decreased thickness and mobility of the pelvic floor muscles (PFM), as well as increased pelvic organ descent (all P < 0.05). Survivors receiving radiotherapy had higher scores on the Pelvic Floor Distress Inventory 20 (PFDI-20) than those undergoing surgery without radiotherapy (P <0.001). Reduced thickness of the PFM (β = -0.42, P <0.001) and increases in descent of pelvic organs (β = 0.48, P <0.001) were independently associated with greater levels of functional impairment. Conclusion: The associations between ultrasound-derived pelvic floor parameters and self-reported functional impairments and symptom burden in gynecologic cancer survivors were significant. Additional prospective longitudinal studies are needed prior to recommending routine clinical implementation of these findings.
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