Pelvic floor disorders and multiple sclerosis: Review of the literature

Multiple Sclerosis (MS) is characterized by multiple demyelinating lesions within the central nervous system by causing a variety of neurological symptoms, including disturbances of the urinary tract function and anorectal function. Despite recent efforts to educate multiple sclerosis health-care providers about the importance of pelvic floor disorders (urinary, bowel, and sexual dysfunction), less data are currently available to assess outcomes of these efforts in terms of patient satisfaction.This article reviews studies assessing the relationship between pelvic floor disorders and multiple sclerosis. Different databases including PubMed, Science Direct, OVID, MEDLINE, and Google Scholar were searched from January 1990 to the present. Two authors independently selected related articles using the same search strategy and key words. Among 180 related articles, 16 met the review inclusion criteria. The study results were described in four sections: 1) urinary dysfunction, 2) bowel dysfunction, 3) sexual dysfunction and 4) management studies.Pelvic floor function is considerably disturbed in multiple sclerosis, showing muscular weakness with preservation of peripheral motor nerve conduction, providing indirect evidence that this is mainly a result of lesions within the central nervous system. While MS patients are generally satisfied with current management of bladder and bowel dysfunction, improvement is needed in that of sexual dysfunction.

Keywords:

Multiple Sclerosis , Pelvic Disorders , Review