A pelvic health eRehabilitation program to address urogenital impairments after breast and gynecologic cancer: A proof-of-concept study protocol

Background Incontinence and vulvar pain are common urogenital dysfunctions after breast and gynecological cancers (BGCs). Recent evidence suggests that pelvic health physiotherapy can improve these dysfunctions and enhance quality of survivorship, but several barriers limit access to such care. Virtual programs are proposed as a strategy to improve access. Aim The main aim of this proof-of-concept study is to evaluate the feasibility and acceptability of the newly designed Pelvic Health eRehabilitation Program in people treated for BGCs. The study also aims to explore the preliminary effectiveness of the Program in reducing urogenital impairments. Methods This study uses a proof-of-concept, interventional prospective cohort design. Twenty individuals with BGCs presenting with urogenital dysfunction (score ≥2 on the Pelvic Floor Bother Questionnaire) will be recruited in the Canadian provinces of Quebec and Alberta. The Program includes twelve weekly small-group online educational sessions with a pelvic health physiotherapist, five individual exercise prescription sessions, and access to a variety of online resources. The following standardized patient-reported outcome measures will be used: the International Consultation on Incontinence modular questionnaires for bladder and bowel symptoms, the Vulvar Pain Assessment Questionnaire, and the Female Sexual Function Index. Evaluations will be conducted before (E1), halfway through (E2), and immediately after (E3) the intervention. Conclusion Findings from this study will inform the feasibility, acceptability, and preliminary effectiveness of the Program for individuals experiencing urogenital dysfunction following BGCs treatment, supporting future development of a randomized controlled trial. This virtual Program holds promise to improve equity in access to pelvic health services.