Pelvic Floor Knowledge, Toileting Behaviors, and Lower Urinary Tract Symptoms in Women with Multiple Sclerosis

Lower urinary tract symptoms (LUTS) are common in women with multiple sclerosis (MS) and may be influenced by neurological involvement as well as behavioral and knowledge-related factors. This study aimed to compare LUTS, pelvic floor health knowledge, and toileting behaviors between women with MS and demographically matched women without MS, examine their associations, and identify predictors of LUTS.

This cross-sectional survey included 59 women with MS and 60 demographically matched women without MS. LUTS were assessed using Urogenital Distress Inventory-6 (UDI-6) and Bristol Women's Lower Urinary Tract Symptoms Questionnaire (BFLUTS). Pelvic floor health knowledge and toileting behaviors were evaluated using Pelvic Floor Health Knowledge Quiz and Toileting Behavior-Women's Elimination Behaviors Scale, respectively.

Women with MS had higher UDI-6 scores, lower pelvic floor health knowledge, and more negative toileting behaviors compared to women without MS (p < 0.05). After adjustment for potential confounders, group differences remained significant for UDI-6, BFLUTS, and premature voiding (p < 0.05), whereas pelvic floor health knowledge was no longer significant (p > 0.05). In both groups, LUTS severity was positively associated mainly with premature voiding and straining voiding (p < 0.05). The final regression model explained 52.2% of the variance in UDI-6 scores; straining to void, premature voiding, and place preference for voiding were significant predictors.

Women with MS had higher LUTS and more negative toileting behaviors, while pelvic floor health knowledge was more closely associated with sociodemographic factors than MS status. These findings underscore the relevance of considering LUTS and toileting behaviors in women with MS.