title: Quality of life issues following surgery for vulval cancer: a case report.
abstract: OBJECTIVE
  Surgical intervention for vulvar cancer and vulvar intraepithelial neoplasia causes mutilation of the genital area and can impose significant bladder, bowel and sexual dysfunction. This case report outlines how conservative interventions such as pelvic floor muscle training (PFMT) may reduce the long-term morbidities of such dysfunction.
  
  
  METHODS
  The patient underwent 16 weeks of PFMT in conjunction with advice on fluid intake and bladder training.
  
  
  RESULTS
  An increase in pelvic floor muscle strength and endurance were recorded. Improved bladder control as demonstrated by a reduction in frequency of voiding (from 15 to 7 per 24 hours), and number of pads used (from 6 to 3 per 24 hours) was evident. The impact of urinary incontinence on everyday life was much less at the end of the treatment period as measured by the Incontinence Impact Questionnaire with a change in score from 21 (maximum impact) to 10.
  
  
  CONCLUSIONS
  These positive results indicate that further research is needed to investigate the effect of PFMT on bladder function following such surgery.
authors.affiliation: Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK. doreen.mclurg@gcal.ac.uk
authors.forename: Doreen
authors.initials: D
authors.lastname: McClurg
authors.forename: Suzanne
authors.initials: S
authors.lastname: Hagen
mesh_terms: D002278:Carcinoma in Situ / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology; D017773:Pelvic Floor; D011183:Postoperative Complications / Q000534:rehabilitation; D011184:Postoperative Period; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology / Q000534:rehabilitation; D014846:Vulvar Neoplasms / Q000601:surgery*