Association between urinary symptoms, quality of life, and pelvic floor function in females diagnosed with multiple sclerosis

Seda Kılıç1, Ayşe Neriman Yılmaz2, Murat Terzi3

1Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Türkiye
2Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant İzzet Baysal University, Bolu, Türkiye
3Department of Neurology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Türkiye

Keywords: Multiple sclerosis, pelvic floor, quality of life, urinary symptoms.

Abstract

Objectives: The study aimed to evaluate the correlation between urinary symptoms, quality of life, and pelvic floor functions in female patients with multiple sclerosis (MS).

Patients and methods: In this descriptive cross-sectional study, 15 females (mean age: 39.6±8.3 years; range, 27 to 56 years) with relapsing-remitting MS were involved between May 2022 and January 2023. The physical and clinical characteristics of the participants were recorded. Information was obtained with the Global Pelvic Floor Distress Inventory (GPFDI), the Bristol Female Lower Urinary Tract Symptoms (BFLUTS) Index, the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the Overactive Bladder-Validated 8-question Screener (OAB-V8), the Urogenital Distress Inventory-6 (UDI-6), the Incontinence Impact Questionnaire-7 (IIQ-7), the King's Health Questionnaire (KHQ), and the Visual Analog Scale (VAS). Pelvic floor function was evaluated using the PERFECT scheme.

Results: Significant correlations were found between urinary symptom severity scores (GPFDI, BFLUTS, ICIQ-SF, UDI-6, IIQ-7, and OAB-V8) and various subdomains of the KHQ, particularly incontinence impact, physical/social limitations, emotional well-being, and sleep/energy. Discomfort levels measured by VAS positively correlated with UDI-6, ICIQ-SF, GPFDI, and KHQ subscores. Higher body mass index, longer disease duration, and higher EDSS scores were associated with greater lower urinary tract symptom severity. Additionally, pelvic floor muscle strength and endurance showed a negative correlation with EDSS scores, as well as several urinary symptoms and quality of life measures.

Conclusion: Urinary symptoms were associated with decreased pelvic floor function, greater physical disability, and reduced quality of life in females with MS.

Cite this article as: Kılıç S, Yılmaz AN, Terzi M. Association between urinary symptoms, quality of life, and pelvic floor function in females diagnosed with multiple sclerosis. Turk J Neurol 2025;31(4):410-417. doi: 10.55697/tnd.2025.323.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Author Contributions

Conception and design, data collection, analysis and interpretation of data, literature search, writing: S.K.; Conception and design, data collection, analysis and interpretation of data, writing: A.N.Y.; Conception, analysis and interpretation of data, writing: M.T.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Acknowledgments

The authors thank Prof. Dr. Yüksel Terzi for his contributions to the statistical analysis.