Abstract
INTRODUCTION AND HYPOTHESIS: This study investigated physical activity (PA) levels and health-related quality-of-life (HRQoL) before and after, and associations between pelvic floor disorders (PFD) and PA/HRQoL after, hysterectomy for gynecological cancer. METHODS: Secondary analysis of a longitudinal cohort study, with assessments before, 6 weeks, and 3 months after hysterectomy for gynecological cancer. The International Physical Activity Questionnaire-short form was used to assess PA and European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-C30 (QLQ-C30) to assess HRQoL. Changes over time were analyzed using generalized estimating equations or linear mixed models. Associations between PFD with PA and HRQoL were analyzed using logistic regressions and analyses of variance. RESULTS: Of 126 participants, median age 63 years, most had endometrial (69%) and/or stage 1 cancer (72%) and underwent total hysterectomy (65%). Pre-surgery, 39% met PA guidelines, increasing to 53% 3 months post-surgery (+14%, 95% CI 2-25). Mean global health status/QoL domain scores from the QLQ-C30 did not change significantly (+4.4/100 points, 95% CI -0.8 to 9.6). Three months post-surgery, whether participants met PA guidelines was not associated with PFD. Participants with anal incontinence or double incontinence had lower global health status/QoL scores than participants without these symptoms (mean (SD) AI 61.4 (17.8) vs no AI 72.5 (18.7), p = 0.006; DI 61.5 (17.9) vs no DI 71.7 (18.8), p = 0.019). CONCLUSION: PA levels were low pre- and post-surgery but worse preoperatively. This presents an opportunity for prehabilitation interventions to optimize physical function. There was no association between meeting PA guidelines and PFD. Global health status/QoL was slightly below population norms pre- and post-surgery. Lower HRQoL was associated with some symptoms of PFD.