Rapid Fire Best of the Best Oral 2025 Joint Meeting of the COSA ASM and IPOS Congress

From Struggle to Strength: Experiences and Outcomes of Pelvic Floor Rehabilitation for Low Anterior Resection Syndrome in Colorectal Cancer Survivors (126407)

Kin Yin Carol Chan 1 2 , Sarah Ratcliffe 2 , Gemma Collett 2 , Michael Suen 1 2 , Susan Coulson 2 , Janindra Warusavitarne 3 , Janette L Vardy 1 2
  1. Concord Repatriation General Hospital, Concord, NSW, Australia
  2. The University of Sydney , Sydney, NSW, Australia
  3. St. Mark's Hospital, London, UK

Objectives/Purpose: Low Anterior Resection Syndrome (LARS) is a prevalent and disruptive consequence of colorectal cancer (CRC) surgery and treatment. This study aimed to understand how bowel symptoms affect daily activities, evaluate the real-world impact of a structured pelvic floor rehabilitation (PFR) program on LARS and quality of life (QOL), assess patient satisfaction with the service, and identify factors influencing rehabilitation outcomes.

 

Methods: A single-arm PFR pilot study enrolled 14 individuals experiencing LARS (LARS score >20/42) at least 6 months after sphincter-preserving anterior resection for CRC, with or without neo/adjuvant therapy or temporary stoma. The PRF consisted of a 10-week structured PFR program. Here, we report on participant feedback collected after the intervention via 1:1 semi-structured exit interviews conducted via telehealth.

 

Qualitative data from 14 interviews were analysed using inductive thematic analysis, guided by a framework mapping approach. Discussions centred on three domains: (1) Daily life disruptions due to LARS, (2) perceived benefits of the PFR program on bowel symptoms and QOL, and (3) satisfaction with the program.

 

Results: All 14 participants reported improvements in bowel frequency, urgency, incontinence, and a regained confidence in social settings after the PFR program. Emergent themes included the physical, psychosocial, and behavioural burdens of LARS, participants’ expectations and knowledge, and the multifaceted impact of PFR. Findings aligned with Symptom Management Theory and the Capability, Opportunity, Motivation, Behaviour (COM-B) model, highlighting PFR’s role in empowering self-efficacy for long-term management and functional recovery through adaptive behavioural strategies.

 

Conclusion and Clinical Implications: This study provides qualitative evidence that structured PFR significantly improves LARS-impacted bowel function and QOL for CRC survivors. High participant satisfaction underscores the program’s acceptability and perceived value. Integrating PFR into standard CRC care, with timely and well-defined referral pathways, and better education regarding LARS, may substantially improve long-term outcomes and optimise CRC care.