Prevalence of Self-Reported Pelvic-Floor-Related Symptoms Among Female Patients with Multiple Sclerosis

Introduction: Multiple sclerosis (MS) is more prevalent among females worldwide. The Expanded Disability Status Scale (EDSS) assesses MS progression, including disability related to pelvic floor dysfunction (PFD), such as bowel and bladder dysfunction. However, data on PFD symptoms in patients with MS remain limited. Objective: To evaluate the prevalence and impact of self- reported pelvic-floor-related symptoms among women with MS in Saudi Arabia and their effects on quality of life (QOL). Methods: A cross-sectional study was conducted among 112 female patients with MS (EDSS ≤ 7, age ≥ 18 years). The participants completed two validated self-reported questionnaires, the Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7), to assess self-reported pelvic-floor-related symptoms and their impact on QOL in women with MS. Results: The most commonly reported symptoms were frequent urination (83%), urge incontinence (70.5%), and constipation (76.8%). Following adjustment for multiple comparisons, increasing age was positively associated with greater urinary symptom distress, overall pelvic-floor-related symptom burden, and greater urinary and prolapse related impact on QOL. In the multivariable analysis, age remained significantly associated with total PFDI-20 scores after adjustment for BMI, MS duration, and marital status. BMI, MS diagnosis duration, and marital status were not significantly associated with total PFDI-20 or PFIQ-7 scores in the multivariable models. Conclusions: Women with MS reported a substantial burden of pelvic-floor-related symptoms, particularly urinary and colorectal anal symptoms, which were associated with adverse effects on physical activities and emotional well-being. These findings highlight the importance of recognizing and assessing pelvic-floor-related symptoms as part of comprehensive care for women with MS.