The effect of pelvic floor muscle training on bowel symptoms after low anterior resection for rectal cancer.

Since several years, low anterior resection, with total mesorectal excision and preservation of the autonomic nerves of the pelvis has become the gold standard for rectal cancer surgery. However, this surgery affects bowel function in 60-90% of patients. These symptoms are referred to as the ‘low anterior resection syndrome’ and are associated with a large negative impact on quality of life. Currently, patients only receive some anti-diarrheal medication, diet advice or the advice to wait for spontaneous improvement. Although pelvic floor muscle training is highly recommended in the treatment of bowel problems in non-cancer populations, there is still no consensus about its effectiveness in rectal cancer patients. In this research we aim (1) to evaluate if patients, who receive 12 weeks of intensive pelvic floor muscle training, have less LARS symptoms then patients who had no treatment; (2) to examine urinary and sexual symptoms, associated with rectal cancer treatment; (3) to assess propulsive colonic contractions and the effect of hindgut denervation on the presence of coordinated proximal to distal contractions; (4) to study the influence of LAR for rectal cancer on all physical activity levels.