Stress Urinary Incontinence Can Often Affect Mothers with Relapsing MS

Stress urinary incontinence affects predominantly young adult mothers with relapsing-remitting multiple sclerosis (RRMS), particularly those with pelvic organ prolapse, according to a recent study. Exercises that strengthen the pelvic floor muscles are suggested to reduce the risk of incontinence.

The study, “Stress Urinary Incontinence in Women With Multiple Sclerosis,” was published in the International Neurology Journal.

Women are three times more likely to be diagnosed with multiple sclerosis (MS) than men, and 50% to 90% of MS patients experience lower urinary tract symptoms. The most common symptoms include urgency and urge incontinence (an involuntary loss of urine that usually occurs when a person has a strong, sudden need to urinate).

The International Continence Society defines stress urinary incontinence as the involuntary leakage of urine upon effort or exertion. Known to affect adult women in particular, its estimates are variable and range from 17% to 41%. In women with MS, the incidence of stress urinary incontinence is still largely unaddressed, and the few studies on the issue also showed wide results (from 16% to 55.9%).

Researchers investigated the prevalence and risk factors of stress urinary incontinence, and the prevalence of intrinsic sphincter deficiency in women with MS. Intrinsic sphincter deficiency is a less common form of stress urinary incontinence.

The team performed a retrospective study involving women with MS, followed for lower urinary tract symptoms during a 15-year period. Its analysis included multiple parameters: demographic data, MS history, expanded disability status scale (EDSS) score at the urodynamic visit, obstetrical past, birth weight, lower urinary tract symptoms, and urodynamic findings. Stress urinary incontinence was defined as incontinence during cough, or any effort; and intrinsic sphincter deficiency as a maximum urethral closure pressure of less than 30 cm H2O.

In total, the study included 363 women with MS (mean age of 46.7, and a mean disease duration of 12.9 years): 60.6% with RRMS, 32.8% with secondary progressive MS, and 6.6% with primary progressive MS.

Researchers detected a 31.4% prevalence of stress urinary incontinence, with intrinsic sphincter deficiency affecting 1.4% of these patients. Additionally, researchers identified specific risk factors, with women with stress urinary incontinence showing significantly higher birth weight, pelvic organ prolapse (i.e., the dropping of pelvic organs, like the bladder, into the vaginal wall, caused by the loss of support from pelvic floor muscles), a lower EDSS score, RRMS, urgent urinary incontinence, and a weaker containing effort.

This study identified a 31.4% prevalence of stress urinary incontinence in female patients with MS. Younger, active mothers with RRMS showed a greater risk of stress urinary incontinence. Since pelvic organ prolapse was found to be a risk factor, researchers suggest that pelvic floor muscle training is probably an effective treatment for stress urinary incontinence.