Proprioception in stress urinary incontinence: A narrative review

Area of Science:

• Urology
• Physiotherapy
• Neuroscience

Background:

• Urinary incontinence (UI) is a prevalent chronic condition, with stress urinary incontinence (SUI) affecting 50% of cases.
• Continence relies on integrated pelvic floor muscles (PFMs), fascial structures, nerves, ligaments, and the vagina.
• Women with SUI exhibit delayed PFM postural activity and reduced balance, suggesting motor control deficits.

Purpose of the Study:

• To systematically review and outline existing literature on the role of proprioception in the pathophysiology of SUI.
• To identify research gaps concerning proprioception's contribution to SUI in women.

Main Methods:

• A systematic literature search was conducted across PubMed, Scopus, and Google Scholar databases.
• The search focused on articles published between 1998 and 2017 concerning SUI pathophysiology, motor control, and proprioception.
• Included studies analyzed motor control alterations and proprioception's role in women with SUI.

Main Results:

• Six articles highlighted proprioception's importance in motor control and its alterations in SUI.
• Literature also covered postural control, balance, and timing deficits in women with SUI.
• Crucially, no studies were found that measured pelvic floor proprioception in women with SUI.

Conclusions:

• Both PFM strength and the timing and proprioception of PFM contractions are critical for maintaining urinary continence.
• Further research investigating pelvic floor proprioception in women with SUI is strongly encouraged to understand its etiological role.