Pelvic floor rehabilitation in cancer survivorship: an umbrella review

This umbrella review aimed to identify, critically appraise, and summarize current systematic reviews with meta-analyses on the role of pelvic floor rehabilitation in cancer survivorship.

Four bibliographic databases were searched from inception to August 1, 2024. Two independent reviewers screened the titles and abstracts of 379 records and retrieved 24 full-text systematic reviews. Assessing the Methodological Quality of Systematic Reviews-2 was used for quality assessment. Qualitative syntheses were performed to compile the effects of pelvic floor rehabilitation on bladder function, bowel function, quality of life, and other outcomes. Measures of effect sizes of these outcomes in each meta-analysis were extracted and summarized.

Seventeen systematic reviews with meta-analyses published between 2012 and 2024 were included in this umbrella review, containing a total of 92 primary studies. For quality assessment, four studies were evaluated as moderate quality, five as low, and eight as critically low. Populations with prostate, colorectal, and gynecological cancer were studied. Effects of pelvic floor rehabilitation on bladder, bowel, sexual function, and quality of life were reported and synthesized.

Pelvic floor rehabilitation is an essential component of cancer survivorship, including following prostate, colorectal, and gynecological cancer surgery. Further high-quality primary studies with adequate sample sizes are needed to inform clinical practice and research endeavors.

This umbrella review highlights the therapeutic potential of pelvic floor rehabilitation, underscores the need for its broader implementation in survivorship care, and guides future research directions to optimize outcomes for cancer survivors.