title: A pilot randomized control trial to evaluate pelvic floor muscle training for urinary incontinence among gynecologic cancer survivors.
abstract: OBJECTIVE
  We previously reported high rates of urinary incontinence among gynecologic cancer survivors and aimed to evaluate the effectiveness of a simple intervention for treatment of urinary incontinence in this population.
  
  
  METHODS
  We recruited 40 gynecologic cancer survivors who reported urinary incontinence on a validated questionnaire. Women were randomized to either pelvic floor muscle training/behavioral therapy (treatment group) or usual care (control group). The primary outcome measure, assessed at 12 weeks post intervention, was a 40% difference in the validated Patient Global Impression of Improvement (PGI-I) score. Fisher's exact test was used to identify differences between groups for frequency data; two-sample t-test was conducted for continuous measurements.
  
  
  RESULTS
  Mean age of this cohort was 57 (range: 37-79). The majority of the survivors had uterine cancer (60%), 18% had received radiation therapy, 95% had received surgical therapy, and 35% had received chemotherapy. At three months, 80% of the treatment and 40% of the control group reported that their urinary incontinence was "much better" or "very much better" as evaluated by the Patient Global Impression of Improvement scale (p=0.02). Brink's scores were significantly improved in the treatment group as compared to those of the controls (p<0.0001). Treatment group adherence was high; the treatment group performed exercises with an average of 22 days/month.
  
  
  CONCLUSIONS
  Urinary incontinence negatively affects quality of life, and despite a high prevalence among gynecologic cancer survivors, it is often under-assessed and undertreated. We found a simple intervention that included pelvic floor muscle training and behavioral therapy, which significantly improved cancer survivor's urinary incontinence.
authors.affiliation: Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA. Electronic address: trutledge@salud.unm.edu.
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Rutledge
authors.affiliation: Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Rogers
authors.affiliation: School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA; Department of Statistics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
authors.forename: Sang-Joon
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
authors.forename: Carolyn Y
authors.initials: CY
authors.lastname: Muller
mesh_terms: D000328:Adult; D000368:Aged; D001521:Behavior Therapy; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications* / Q000401:mortality; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor; D010865:Pilot Projects; D017741:Survivors; D014549:Urinary Incontinence / Q000209:etiology / Q000628:therapy*
keywords: Cancer survivorship; Quality of life; Urinary incontinence