Core Stability in Women With and Without Lower Urinary Tract Symptoms: The CORE-LUTS Study

Lower urinary tract symptoms (LUTS) are highly prevalent in women. Core instability and physical activity (PA) may be associated with LUTS. The study hypothesized that compared with healthy controls, women with LUTS would have differences in core stability scores, reduced PA levels, and LUTS symptom severity would correlate inversely with core stability.

This cross-sectional cohort study recruited women aged 18-70 with and without LUTS. Participants completed demographics, Urinary Distress Inventory Short Form (UDI-6), Godin Shephard Leisure Time Exercise Questionnaire (Godin), a novel Resistance Activity Questionnaire (RAQ), and Core Score testing. Summary statistics were provided overall and by LUTS diagnosis. Wilcoxon rank sum tests compared median aerobic physical activity (aPA)/resistance physical activity (rPA) between groups. Regression analyses estimated the effects of LUTS and UDI-6 severity on core stability.

A total of 48 women with LUTS and 49 women without LUTS participated (mean age 46 ± 12, BMI 32 ± 8). Women with LUTS were older (mean, SD 51, 12 vs 43, 13, p < 0.01) with higher parity (2, 1 vs 1, 1, p < 0.01), and higher constipation (n, %: 10, 21 vs 3, 6, p = 0.03), dyspareunia (12, 25 vs 2, 4, p < 0.01), and current formal core exercise instruction (10, 21 vs 3, 6, p = 0.03). After adjusting for age, BMI, and parity, women with LUTS had lower Core Scores (mean difference; 95% CI -1.08; -1.99, -0.18, p < 0.01); PA levels did not differ on Godin (median, IQR 21.5, 10 to 39.5 vs 21, 11 to 46, p = 0.58) or RAQ (0, 0 to 6 vs 2, 0 to 6, p = 0.12), and UDI symptom severity increases of 10 units correlated inversely with Core Scores (mean effect, 95% CI -0.32, -0.53, -0.10, p < 0.01).

Women with LUTS had small, significantly worse core stability scores, but APA and rPA levels did not differ. LUTS severity was associated with worse core stability. Further research may help to determine association versus causation.