The effectiveness of pelvic rehabilitation Program on genitourinary syndrome in a breast cancer survivor: a case report

Breast cancer survivors often experience genitourinary syndrome of menopause (GSM) due to estrogen-suppressing treatments, leading to urinary incontinence, vaginal dryness, and dyspareunia. A 48-year-old breast cancer survivor with a history of stage II HER-2 positive breast cancer and GSM presented with stress urinary incontinence (7–8 times weekly), moderate dyspareunia, and vaginal dryness. The patient underwent a three-month pelvic rehabilitation program, including pelvic floor muscle training with biofeedback, manual therapy, and a tailored home exercise regimen focused on pelvic stabilization and tissue extensibility. Post-treatment assessments demonstrated significant improvements. Pelvic floor strength increased from 3/5 to 4+/5, and electromyography revealed a reduction in resting muscle tone from 6.6 microvolts to 1.3 microvolts, indicating improved neuromuscular coordination. The patient’s International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form score improved from 11 to 0, indicating complete resolution of urinary incontinence. Vaginal dryness and dyspareunia decreased, with pain during intercourse reducing from 6/10 to 4/10. Pelvic rehabilitation successfully assisted in the management of GSM symptoms in this individual patient two years following cancer treatment. While improvements suggest that a multidisciplinary approach may help manage GSM, these findings are preliminary. Further research is needed to determine long-term efficacy and broader applicability.