Pelvic Floor Disorders in Survivors of Gynecologic Malignancies

Pelvic floor disorders negatively impact the quality of life of those afflicted by pelvic
organ prolapse, lower urinary tract symptoms, defecatory or sexual dysfunction, or pain.
Women who present for routine gynecologic care often have undiagnosed pelvic floor
disorders, and physicians may not specifically question women to elicit pelvic floor
symptoms. In the United States 24% of women report at least one pelvic floor disorder,
which increases with age, parity , obesity. Gynecologic cancer survivors are a unique
population who undergo a variety treatment regimens including surgery, chemotherapy, and
radiation. Radical hysterectomy, a common surgical treatment for gynecologic cancers, is a
well-established cause for lower urinary tract dysfunction. In contrast, data are lacking
regarding risk factors for pelvic organ prolapse or fecal incontinence. Survivors of
gynecologic malignancies may be at increased risk for symptomatic pelvic floor disorders,
but may not be diagnosed due to lack of inquiry of these symptoms by practitioners. In
addition, a recent qualitative study found that survivors of gynecologic malignancies
believed that pelvic floor symptoms were an inevitable, untreatable corollary to treatment
for their cancer and thus did not seek treatment. Furthermore, the study participants
reported that they felt healthy despite these symptoms because of their oncologists
assessment of their remission status. The lack of diagnosis and treatment of pelvic floor
disorders has clinical and quality of life implications for the growing numbers of
gynecologic malignancy survivors. The objective of this study is to identify the prevalence
of an risk factors for pelvic floor disorders in women after treatment for gynecologic
cancer. Our rationale for this project is that the investigators believe that pelvic floor
disorders affect the quality of life of gynecologic cancer survivors and should be
quantified. Successful completion of this study will provide evidence for practitioners to
screen and treat pelvic floor disorders in gynecologic malignancy survivors.

Inclusion Criteria:

- Women with documented surgery for gynecologic malignancies at any of the three UPHS
associated hospitals in center city Philadelphia (e.g., HUP, Pennsylvania hospital)
and an accessible electronic medical record from the time of cancer diagnosis and
beyond.

- Gynecologic cancer survivors at least 20 years of age diagnosed and treated for
uterine, ovarian, peritoneal, fallopian tube, cervical, or vulvar tumors between 2008
to July 2010 will be included

Exclusion Criteria:

- Women who are pregnant, with benign tumors, those lost to follow-up, or deceased will
be excluded from this study.

- Patients unable to complete a written survey due to physical or mental disabilities
will also be excluded.