Prevalence of stress urinary incontinence in women with multiple sclerosis
Dr Caroline MASSOTa, Dr Hichem KHENIOUIa, Prof Patrick HAUTECOEURa, Dr Cécile DONZEa
a Hôpital Saint Philibert
Purpose: We report the prevalence and risk factors of stress urinary incontinence (SUI), and the prevalence of intrinsic urethral sphincter deficiency in women with multiple sclerosis (MS).
Materials and Methods:
We conducted a retrospective, single-site, institutional review board-approved study. Demographic and urodynamic data on all female patients with MS followed in the rehabilitation center of Lille Catholic Hospital for lower urinary tract symptoms in a 15-year period (december 1999 to june 2014). Demographic and urodynamic informations were collected. SUI was defined as a complaint of involuntary leakage on effort or exertion, or coughing. Intrinsic urethral sphincter deficiency was defined by a maximum urethral closure pressure inferior to 110 - age. Univariate analysis was performed using Student’s t-tests and Chi 2 tests. Multivariate analysis was performed using logistic regressions. P-values lower than 0.05 were considered statistically significant.
Results: 400 female patients were referred to the center. 365 patients were reviewed and 2 patients were excluded because they had an indwelling catheter. Included in the analysis were 363 women, mean age was 46.7 ± 10.8 years. The prevalence of SUI was 31.4%. The global prevalence of intrinsic urethral sphincteric deficiency was 17.9%, 22.8% in women with SUI versus 15.7% in women without SUI (p = 0.2).
In univariate analyses, patients with relapsing remitting (RR) MS were more likely to have SUI than patients with primary or progressive MS (p = 0.017).
In multivariate analyses, women with a SUI had significantly higher newborn weights (p = 0.03), more often pelvic prolapses (p = 0.021), urgentury urinary incontinences (p = 0.006), anticholinergic drugs (p = 0.003), lower EDSS scores (p= 0.019) and weaker (p = 0.0001) or impossible (p < 0.0001) containing efforts.
Conclusions: RR MS patients and patients with a low EDSS score are more likely to have SUI. This symptom could affect the quality of life of women with multiple sclerosis.
Keywords : stress urinary incontinence, multiple sclerosis