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Pelvic floor function in multiple sclerosis

J S Jameson1, J Rogers, Y W Chia

  • 1Department of Gastroenterology and Nutrition, Central Middlesex Hospital, London.

Gut
|March 1, 1994
PubMed
Summary
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Multiple sclerosis patients exhibit significant pelvic floor muscular weakness, impacting bowel function. This dysfunction stems from central nervous system lesions, not peripheral nerve damage.

Area of Science:

  • Neurology
  • Gastroenterology
  • Pelvic Floor Disorders

Background:

  • Bowel dysfunction is common in multiple sclerosis (MS).
  • Pelvic floor dysfunction contributes to bowel issues like incontinence and defecation difficulties.
  • Understanding MS-related pelvic floor changes is crucial for patient management.

Purpose of the Study:

  • To define pelvic floor function in multiple sclerosis patients with bowel dysfunction.
  • To compare MS patients (incontinent and continent) with normal controls and idiopathic fecal incontinence (FI) patients.
  • To elucidate the neurological basis of pelvic floor dysfunction in MS.

Main Methods:

  • Studied 38 MS patients (20 incontinent, 18 continent), 73 normal controls, and 91 FI patients.
  • Assessed pelvic floor function using anal pressures (resting and voluntary contraction) and external anal sphincter (EAS) electromyography.

Related Experiment Videos

  • Measured pudendal nerve terminal motor latencies and sensory thresholds.

    • Main Results:

    • MS patients showed lower anal resting and voluntary contraction pressures compared to controls.
    • MS patients had higher EAS fiber densities but normal pudendal nerve latencies and sensory function.
    • FI patients exhibited sensorimotor deficits, including increased latencies and lower pressures, distinct from MS patients.

    Conclusions:

    • Pelvic floor function is significantly disturbed in multiple sclerosis, characterized by muscular weakness.
    • The findings suggest MS-related pelvic floor dysfunction primarily results from central nervous system lesions.
    • Incontinence in MS is linked to lower voluntary anal contraction pressures.