Antoniadis Georgios, Tsikopoulos Ioannis, Tsionga Aikaterini, Galanoulis Konstantinos, Bousdroukis Nikolaos, Samarinas Michael
Department of Urology, General Hospital of Larissa, Tsakalof 1 Str, Larissa 41221, Greece.
Department of Neuro-urology, Royal National Orthopaedic Hospital, London W1W 5AQ, United Kingdom.
Bladder (San Franc). 2025 Jan 17;11(4):e21200028. doi: 10.14440/bladder.2024.0049. eCollection 2024.
Stress urinary incontinence (SUI), characterized by involuntary urine leakage during increased abdominal pressure, is prevalent among women with multiple sclerosis (MS), significantly impacting their quality of life (QoL). Traditional treatments are less suitable for MS patients due to potential complications, highlighting the need for less invasive alternatives, , urethral bulking agents (UBAs) and pelvic floor muscle training (PFMT). UBAs increase urethral tissue volume, while PFMT strengthens pelvic muscles. Despite promising outcomes, their efficacy in MS-related SUI is under-researched.
This study assessed the effectiveness of UBAs and PFMT in managing SUI among female patients with MS.
This nine-month study involved 14 female MS patients with moderate SUI, who were equally divided into two groups to evaluate the effectiveness of UBAs and PFMT. UBAs were administered through injections to enhance urethral resistance, while PFMT used guided exercises to improve pelvic control. Outcomes were assessed in terms of urinary pad usage, scores of International Consultation on Incontinence Questionnaire-Short Form, and QoL metrics to evaluate reductions in incontinence and symptom severity.
Both treatment groups showed significant improvement with SUI management. Daily pad usage decreased to 0-1 in both groups, with reductions in symptom severity and improvements in QoL scores. UBAs provided quicker symptomatic relief, while PFMT supported long-term management. However, two participants in the PFMT group discontinued follow-up due to MS-related complications, highlighting the challenges of maintaining adherence in progressive conditions.
UBAs and PFMT are effective management options for SUI in MS patients, improving symptom control and QoL. This study underscored the importance of individualized, multimodal approaches to optimize outcomes for women with MS-related SUI. Nevertheless, further research is needed for long-term validation.
压力性尿失禁（SUI）的特征是在腹压增加时出现不自主漏尿，在多发性硬化症（MS）女性患者中很常见，严重影响她们的生活质量（QoL）。由于存在潜在并发症，传统治疗方法不太适合MS患者，这凸显了对侵入性较小的替代方法的需求，即尿道填充剂（UBAs）和盆底肌肉训练（PFMT）。UBAs可增加尿道组织体积，而PFMT可增强盆底肌肉。尽管有前景良好的结果，但它们在MS相关SUI中的疗效研究不足。
本研究评估了UBAs和PFMT对MS女性患者SUI的管理效果。
这项为期九个月的研究纳入了14名患有中度SUI的女性MS患者，她们被平均分为两组以评估UBAs和PFMT的效果。通过注射给予UBAs以增强尿道阻力，而PFMT采用指导性锻炼来改善盆底控制。根据尿垫使用情况、国际尿失禁咨询委员会简表评分和QoL指标来评估结果，以评估尿失禁和症状严重程度的降低情况。
两个治疗组在SUI管理方面均显示出显著改善。两组的每日尿垫使用量均降至0 - 1片，症状严重程度降低，QoL评分提高。UBAs能更快缓解症状，而PFMT有助于长期管理。然而，PFMT组有两名参与者因MS相关并发症而停止随访，这凸显了在进展性疾病中维持依从性的挑战。
UBAs和PFMT是MS患者SUI的有效管理选择，可改善症状控制和QoL。本研究强调了个体化、多模式方法对于优化MS相关SUI女性患者治疗效果的重要性。尽管如此，仍需要进一步研究进行长期验证。
