Biofeedback-Assisted Pelvic Floor Rehabilitation for Radiation-Induced Sexual Dysfunction in Cervical Cancer Survivors

Inclusion Criteria:

1. Female participants aged 30-60 years.
2. Histologically confirmed diagnosis of cervical cancer (any stage at diagnosis) and completion of primary treatment.
3. Completion of pelvic radiotherapy (external beam radiotherapy and/or brachytherapy) ≥3 months prior to enrollment.
4. Presence of radiation-induced sexual dysfunction, defined as a Female Sexual Function Index (FSFI) score ≤26.55.
5. Self-reported sexual activity within the previous 6 months.
6. Medically stable with no current oncologic indication for active treatment, confirmed by treating oncologist.
7. Ability to understand study procedures and provide written informed consent.

Exclusion Criteria:

1. Evidence of recurrent, persistent, or metastatic cervical cancer.
2. Participation in pelvic floor muscle training or biofeedback-based rehabilitation within the previous 6 months.
3. Presence of severe pelvic organ prolapse (stage III-IV).
4. Active pelvic infection, pelvic inflammatory disease, or untreated vaginal infection.
5. Ongoing significant vaginal bleeding of unknown or pathological origin.
6. Untreated or active urinary tract infection at the time of enrollment.
7. Neurological disorders affecting pelvic floor function (e.g., spinal cord injury, multiple sclerosis).
8. Severe psychiatric illness or uncontrolled mental health disorder affecting participation.
9. Cognitive impairment preventing understanding of instructions or adherence to protocol.
10. Current pregnancy or planning pregnancy during the study period.
11. Participation in another interventional clinical or rehabilitation trial within the last 3 months or during the study period.