International Urogynecology Journal

, Volume 29, Issue 4, pp 459–476 | Cite as

Pelvic floor disorders in women with gynecologic malignancies: a systematic review

  • Aparna S. RamaseshanEmail author
  • Jessica Felton
  • Dana Roque
  • Gautam Rao
  • Andrea G. Shipper
  • Tatiana V. D. Sanses
Review Article


Introduction and hypothesis

Pelvic floor disorders (PFDs) negatively affect quality of life in the general population, and their prevalence in gynecologic cancer survivors has not been systematically described. This study aimed to determine the prevalence of PFDs in cancer survivors. We hypothesized that the prevalence of PFDs in the gynecologic cancer population would be higher than in the general female population.


We searched PubMed (1809 to present), EMBASE (1974 to present), and the Cochrane Central Register of Controlled Trials (CENTRAL) through May 2017. The search combined subject headings, title, and abstract words for gynecologic cancer, PFDs, and prevalence. Any studies evaluating the prevalence of PFDs in gynecologic malignancies were included.


A total of 550 articles met the designated search criteria and 31 articles were included in this review. In cervical cancer survivors, before treatment the prevalences of stress urinary incontinence (SUI), urgency urinary incontinence (UUI) and fecal incontinence (FI) were 24–29%, 8–18% and 6%, respectively, and after treatment the prevalences of SUI, UUI, urinary retention, FI, fecal urge, dyspareunia and vaginal dryness were 4–76%, 4–59%, 0.4–39%, 2–34%, 3–49%, 12–58% and 15–47%, respectively. In uterine cancer survivors, before treatment the prevalences of SUI, UUI and FI were 29–36%, 15–25% and 3%, respectively, and after treatment the prevalences of urinary incontinence (UI) and dyspareunia were 2–44% and 7–39%, respectively. In vulvar cancer survivors, after treatment the prevalences of UI, SUI and FI were 4–32%, 6–20% and 1–20%, respectively. In ovarian cancer survivors, the prevalences of SUI, UUI, prolapse and sexual dysfunction were 32–42%, 15–39%, 17% and 62–75%, respectively.


PFDs are prevalent in gynecologic cancer survivors and this is an important area of clinical concern and future research.


Prevalence Pelvic floor disorders Gynecologic cancer Survivor 


Compliance with ethical standards

Conflicts of interest

Dr. Sanses was supported by Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) K12 HD43489 from the National Institute of Child Health and Human Development at the time of the study, and by the National Institute on Aging (1R03AG053281–01).

The other authors have no conflicts of interest to disclose.


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Copyright information

© The International Urogynecological Association 2017

Authors and Affiliations

  1. 1.Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Department of SurgeryUniversity of Maryland School of MedicineBaltimoreUSA
  3. 3.Health Sciences & Human Services LibraryUniversity of Maryland School of MedicineBaltimoreUSA

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