Bekkenbodemsrevalidatie bij preventie van postoperatieve darmsymptomen na colorectale chirurgie

PURPOSE: This study aimed to evaluate the effects of pelvic floor rehabilitation on the prevention and treatment of bowel symptoms in patients with rectal cancer. METHODS: PubMed, Embase, Web of Science, The Cochrane Library, CINAHL Plus with Full Text, and ProQuest were searched from inception to August 31, 2025. Eligible randomized controlled trials (RCTs) investigating pelvic floor rehabilitation for the prevention or treatment of bowel symptoms were included. Risk of bias was evaluated using the Cochrane Risk of Bias tool version 2, and the certainty of evidence was assessed with the GRADE approach. Statistical analyses were performed using RevMan 5.4. RESULTS: A total of 12 RCTs were included. For prevention, pelvic floor rehabilitation was associated with significantly lower Wexner incontinence scores at 1 month (MD - 2.78, 95% CI - 4.57 to - 0.98) and 6 months after surgery (MD - 3.26, 95% CI - 5.64 to - 0.89). However, no significant differences were observed at 3 or 12 months. Low anterior resection syndrome (LARS) scores likewise showed no significant difference at 3 months postoperatively. For treatment, pelvic floor rehabilitation significantly reduced Wexner incontinence scores (MD - 1.77, 95% CI - 2.40 to - 1.14) as well as LARS scores (MD - 4.07, 95% CI - 6.85 to - 1.29). According to the GRADE assessment, the certainty of evidence for both prevention and treatment ranged from low to very low. CONCLUSIONS: Pelvic floor rehabilitation appears to be beneficial for the prevention and treatment of postoperative bowel symptoms. However, the certainty of the evidence remains low, and further high-quality RCTs are required. IMPLICATIONS FOR CANCER SURVIVORS: Pelvic floor rehabilitation appears to offer benefits in the prevention and treatment of postoperative bowel symptoms in patients with rectal cancer. However, the findings should be interpreted with caution due to potential bias, and further well-designed RCTs are required. TRIAL REGISTRATION: This review was registered with PROSPERO (Number: CRD420251117927)).