Physical therapy in the management of pelvic floor dysfunction after cancer surgery: A literature review

Abstract

Introduction: Pelvic floor dysfunctions are common after oncological surgeries and may include urinary and fecal incontinence, pelvic pain, sexual dysfunction, decreased muscle strength and coordination, and significant impairment in quality of life. These changes result from surgical trauma, nerve injury, radiotherapy effects, postoperative complications, and psychosocial factors, requiring an interdisciplinary approach that integrates physical therapy, medical follow-up, and patient education to optimize functional recovery. Objective: This review analyzed the role of physical therapy in the management of pelvic floor dysfunctions following oncological surgeries, identifying effective therapeutic strategies, functional rehabilitation protocols, and mechanisms of collaborative care. Methods: TThis descriptive and analytical literature review was developed based on national and international publications found in the Virtual Health Library (VHL), the Latin American and Caribbean Health Sciences Literature (LILACS), PubMed – U.S. National Library of Medicine (PubMed), and Scopus databases. Eleven studies published between 2016 and 2025 were included, selected according to their relevance to postoperative pelvic floor dysfunctions, physiotherapeutic interventions, functional outcomes, and interdisciplinary care strategies. Results: Evidence shows that structured rehabilitation programs involving pelvic floor muscle training, manual therapy, neuromuscular reeducation, biofeedback, electrotherapy, and health education significantly improve continence, pelvic coordination, sexual function, pain levels, and overall quality of life. When combined with medical follow-up, including monitoring for postoperative complications, management of neuropathic pain, support for bowel and urinary symptoms, and individualized clinical guidance, physiotherapy demonstrates superior results in functional recovery and long-term complication prevention. Multidisciplinary programs, educational support, and continuity-of-care strategies, including telerehabilitation, proved essential for adherence, engagement, and maintenance of therapeutic gains. Conclusion: The interdisciplinary integration of physical therapy and medicine is fundamental in the management of pelvic floor dysfunctions after oncological surgeries. Evidence-based and individualized protocols that combine therapeutic exercises, continuous clinical monitoring, and biopsychosocial strategies promote functional recovery, postural stability, continence, and autonomy. This collaborative model reinforces the importance of coordinated care and patient-centered rehabilitation as essential pillars in contemporary pelvic oncology recovery.