A Study to Assess the Effect of Pelvic Floor Muscle Strengthening Exercises on Urinary Incontinence in Patients with Cervical Cancer Undergoing Radiation Therapy at a Tertiary Cancer Centre

Abstract

OBJECTIVES - The objective was to analyse the effect of pelvic floor muscle strengthening exercises on urinary incontinence in patients with cervical cancer undergoing radiation therapy at a tertiary cancer centre. METHODS - This study included 45 cervical cancer patients undergoing radiation therapy, using a non-probability convenience sampling technique and a quasi-experimental one-group pre-post design. The intervention consisted of four pelvic floor muscle strengthening exercises including a) Kegel exercise, b) Squeeze and release, c) Pelvic floor/inner thigh ball squeeze, d) Lower trunk rotation / Lying hip rotation. These exercises were demonstrated with the help of a model pamphlet and were performed four times daily. The total duration of the four exercises was 18-20 minutes, over a period of 12 weeks. Daily follow-ups were conducted and a logbook was maintained for compliance. The patients were assessed for urinary incontinence using the ICIQ UI-SF tool and a perineometer on the 8th and 12th weeks. The statistical evaluation plan involved summarising the demographic and clinical data with descriptive statistics. The primary objectives were evaluated with the Friedman test and one-way ANOVA test, while the secondary objectives were evaluated with frequency distribution and chi-square t-test. RESULTS OF THE STUDIES - In this study, 45 women received the intervention; however, only 43 women completed the intervention and follow-up. The results showed that the frequency and quantity of urinary incontinence significantly reduced from the patient’s baseline parameters. It was observed that the participants’ ICIQ UI SF total score on the pre-test had a mean of 12.56 (SD±3.74), after 8 weeks of intervention the mean was 11.33 (SD±3.48), and after 12 weeks of intervention the mean was 8.86 (SD±2.97). The P-value was statistically significant (p <0.001). There was a significant (P <0.001) improvement in the quality of life of the participants. The research hypothesis was accepted. There was significant (p <0.001) alleviation in urinary incontinence after pelvic floor muscle strengthening exercises in patients with cervical cancer undergoing radiation therapy. The pelvic floor muscle contractility on the perineometer on pre-intervention had a mean of 21.63 (SD±2.71), after 8 weeks of intervention the mean was 22.33 (SD±2.65), and after 12 weeks the mean was 23.49 (SD±2.16). The pelvic floor muscle strengthening exercises statistically significantly (p <0.001) proved the improvement in pelvic floor muscle strength. CONCLUSION - The results of this study suggest that pelvic floor muscle strengthening exercises were effective for alleviating urinary incontinence, which improved the quality of life of patients with cervical cancer undergoing radiation therapy. It is a statistically significant intervention.