Reimus Michalina, Siemiński Mariusz
Emergency Department, University Clinical Centre, 80-214 Gdansk, Poland.
Department of Emergency Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland.
J Clin Med. 2025 May 16;14(10):3509. doi: 10.3390/jcm14103509.
Multiple Sclerosis (MS) is an inflammatory autoimmune disorder that primarily affects the central nervous system, leading to significant disability in young adults, with a higher prevalence observed in women. The heterogeneous clinical presentation of MS poses substantial challenges in diagnosis and treatment. In recent years, considerable emphasis has been placed on improving the quality of life for MS patients, with sexual health being a key component of this assessment. The literature suggests that sexual dysfunctions affect between 42% and 73% of individuals with MS. While the positive effects of physiotherapy interventions on sexual dysfunction have been extensively studied, there remains a significant gap in understanding the prevalence of these disorders within the MS population and the most effective treatment approaches. This review highlights the critical need to integrate pelvic floor physiotherapists into multidisciplinary MS treatment teams. Six randomized controlled trials (RCTs) meeting the inclusion criteria were identified. These studies included patients diagnosed with MS who reported various sexual dysfunctions, such as orgasmic dysfunction, sexual arousal disorders, and dysfunctions associated with overactive bladder. The outcomes were assessed using sexual function and urological symptom questionnaires. Physiotherapeutic interventions, including manual therapy, kinesiotherapy, and physical therapy elements, have demonstrated positive effects on sexual quality of life, specifically in relation to issues such as desire, arousal, and satisfaction. However, the available data are still preliminary and warrant further investigation. By recognizing the importance of pelvic floor therapy, more targeted and holistic interventions can be implemented, ultimately improving patient outcomes and enhancing the overall standard of care.
多发性硬化症（MS）是一种炎症性自身免疫性疾病，主要影响中枢神经系统，导致年轻成年人出现严重残疾，女性患病率更高。MS的临床表现具有异质性，在诊断和治疗方面带来了巨大挑战。近年来，人们相当重视改善MS患者的生活质量，性健康是这一评估的关键组成部分。文献表明，性功能障碍影响42%至73%的MS患者。虽然物理治疗干预对性功能障碍的积极作用已得到广泛研究，但在了解MS人群中这些疾病的患病率以及最有效的治疗方法方面仍存在重大差距。本综述强调了将盆底物理治疗师纳入多学科MS治疗团队的迫切需求。确定了六项符合纳入标准的随机对照试验（RCT）。这些研究包括被诊断为MS且报告有各种性功能障碍的患者，如性高潮功能障碍、性唤起障碍以及与膀胱过度活动相关的功能障碍。使用性功能和泌尿系统症状问卷评估结果。物理治疗干预，包括手法治疗、运动疗法和物理治疗要素，已对性生活质量产生积极影响，特别是在性欲、性唤起和满意度等问题方面。然而，现有数据仍然是初步的，需要进一步研究。通过认识到盆底治疗的重要性，可以实施更有针对性和整体性的干预措施，最终改善患者预后并提高整体护理标准。
