Skip to main content

Advertisement

SpringerLink
Log in

Lower urinary tract symptoms and perineal function in women with and without fibromyalgia: a cross-sectional study

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

Fibromyalgia (FM) studies have focused on pain, but a 2010 review of the diagnostic criteria pointed to other symptoms including urinary incontinence (UI). Women with FM present pain, fatigue, and reduced muscle strength; the research hypothesis was that pelvic floor (PF) muscles would be weaker; therefore, FM could be associated with lower urinary tract symptoms (LUTS) and compromise quality of life (QoL). The aim of this paper was to compare PF function, urinary symptoms, and their impact on QoL in women with and without FM and to verify if there is association between FM and LUTS.

Methods

We performed a cross-sectional study with 126 sexually active women aged between 19 and 65 years old, distributed in two groups, women with FM (FG n = 62) and without FM (NFG n = 64). Perineal function was the primary outcome and was assessed by perineometry and bidigital vaginal palpation (PERFECT Scheme). Presence of LUTS was assessed by interview based on international definition, and the impact of UI on QoL was evaluated by the King’s Health Questionnaire (KHQ).

Results

FG presented worse PF function on clinical exam (p < 0.001) and perineometry (p = 0.04). LUTS was more frequent among FG (p < 0.001). In terms of QoL, FG obtained lower KHQ scores for general health perception (p < 0.001) and sleep/energy (p < 0.003) domains. The odds of presenting LUTS is 5.03 (95%CI 2.35–10.75) higher in women with FM.

Conclusion

Women with FM had worse perineal function, had more LUTS, and presented UI more frequently, which negatively impacts on QoL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Wolfe F, Smythe HA, Yunus MB, Bennet RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, Fam AG, Farber SJ, Fiechtner JJ, Franklin CM, Gatter AR, Hamaty R, Lessard J, Lichtbroun AS, Gatter RA, Hamaty D, Lessard J, Lichtbroun AS, Masi AT, McCain GA, Reynolds WJ, Romano TJ, Russel TJ, Shein RT (1990) American College of Rheumatology 1990 criteria for classification of fibromyalgia. Arthritis Rheum 33(2):160–171

    Article  CAS  Google Scholar 

  2. Wolfe F, Clauw DJ, Fitzcharles M, Goldenberg DL, Katz RS, Mease P, Russel AS, Russel IJ, Winfield JB, Yunus MB (2010) The American College of Rheumatology Preliminary Diagnostic Criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res 62(5):600–610. https://doi.org/10.1002/acr.20140

    Article  Google Scholar 

  3. Wolfe F (2017) Criteria for fibromyalgia? What is fibromyalgia? Limitations to current concepts of fibromyalgia and fibromyalgia criteria. Clin Exp Rheumatol 35 Suppl 105(3):3–5

    PubMed  Google Scholar 

  4. Jones KD, Maxwel C, Mist SD, King V, Denman MA, Gregory WT (2015) Pelvic floor and urinary distress in women with fibromyalgia. Pain Manag Nurs 16(6):834–840. https://doi.org/10.1016/j.pmn.2015.06.001

    Article  PubMed  PubMed Central  Google Scholar 

  5. Adams K, Osmunden B, Gregory WT (2014) Does fibromyalgia influence symptom bother from pelvic organ prolapse? Int Urogynecol J 25(5):677–682. https://doi.org/10.1007/s00192-013-2280-y

    Article  PubMed  Google Scholar 

  6. Stormorken H, Brosstad F (2005) Frequent urination - an important diagnostic marker in fibromyalgia. Tidsskr Nor Laegeforen 125(1):17–19

    PubMed  Google Scholar 

  7. Araújo MP, Faria AC, Takano CC, Oliveira E, Sartori MCF, Pollak DF, Girão MJBC (2008) Urodynamic study and quality of life in patients with fibromyalgia and lower urinary tract symptoms. Int Urogynecol J Pelvic Floor Dysfunct 19(8):1103–1107

    Article  Google Scholar 

  8. Laycock J, Jerwood D (2001) Pelvic floor muscle assessment: the PERFECT scheme. Physiotherapy. 87:631–642

    Article  Google Scholar 

  9. Sapsford RR, Hodges PW, Richardson CA, Cooper DH, Markwell SJ, Jull GA (2001) Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn 20:31–42. https://doi.org/10.1002/1520-6777(2001)20:1<31::AID-NAU5>3.0.CO;2-P

    Article  CAS  PubMed  Google Scholar 

  10. Bo K, Sherburn M (2005) Evaluation of female pelvic-floor muscle function and strength. Phys Ther 85(3):269–282. https://doi.org/10.1093/ptj/85.3.269

    Article  PubMed  Google Scholar 

  11. Haylen BT, Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk ED, Sand PK, Schaer GN (2010) An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21:5–26

    Article  Google Scholar 

  12. Fonseca ESM, Camargo ALM, Castro RA, Sartori MGF, Fonseca MCM, Lima GR, Girão MJBC (2005) Validação do questionário de qualidade de vida (King’s Health Questionnaire) em mulheres brasileiras com incontinência urinária. Rev Bras Ginecol Obstet 27(5):235–242. https://doi.org/10.1590/S0100-72032005000500002

    Article  Google Scholar 

  13. Pamuk ON, Dönmez S, Cakir N (2009) Increased frequencies of hysterectomy and early menopause in fibromyalgia patients: a comparative study. Clin Rheumatol 28:561–564. https://doi.org/10.1007/s10067-009-1087-1

    Article  PubMed  Google Scholar 

  14. Chung JH, Kim SA, Choi BY, Lee H, Lee SW, Kim YT, Lee TY, Moon HS (2013) The association between overactive bladder and fibromyalgia syndrome: a community survey. Neurourol Urodyn 32:66–69. https://doi.org/10.1002/nau.22277

    Article  PubMed  Google Scholar 

  15. Gameiro MO, Sousa VO, Gameiro LF, Muchaih RC, Padovani CR, Amaro JL (2011) Comparison of pelvic floor muscle strength evaluations in nulliparous and primiparous women: a prospective study. Clinics. 66(8):1389–1383. https://doi.org/10.1590/S1807-59322011000800014

    Article  PubMed  PubMed Central  Google Scholar 

  16. Bernestein IT (1997) The pelvic floor muscles: muscle thickness in healthy and urinary-incontinent women measured by perineal ultrasonography with reference to the pelvic floor training. Estrogen receptor studies. Neurourol Urodyn 16(4):237–275. https://doi.org/10.1002/(SICI)1520-6777(1997)16:4<237::AID-NAU2>3.0.CO;2-F

    Article  Google Scholar 

  17. Harris SS, Link CL, Teenstedt SL, Kusek JW, Mackinlay JB (2007) Care seeking and treatment for urinary incontinence in a diverse population. J Urol 177:680–684. https://doi.org/10.1016/j.juro.2006.09.045

    Article  PubMed  Google Scholar 

  18. Knorst MR, Resende TL, Goldim JR (2011) Perfil clínico, qualidade de vida e sintomas depressivos de mulheres com incontinência urinária atendidas em hospital-escola. Rev Bras Fis 15(2):109–166. https://doi.org/10.1590/S1413-35552011000200005

    Article  Google Scholar 

Download references

Funding

This study received funds from CAPES (Coordination for the Improvement of Higher Education Personnel - Government Research Agency) with scholarship to the first author (CAPES - 1567403).

Author information

Authors and Affiliations

  1. Department of Physiotherapy, Speech Therapy and Occupational Therapy, Faculty of Medicine, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária, São Paulo, Brazil

    Hellen Cristina Souza de Carvalho Fusco, Amélia Pasqual Marques & Elizabeth Alves Gonçalves Ferreira

  2. Department of Rheumatology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil

    Marco Antônio Gonçalves Pontes Filho

  3. Department of Obstetrics and Gynecology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil

    Jorge Milhem Haddad

  4. Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), São Paulo, Brazil

    Míriam Raquel Diniz Zanetti

Authors
  1. Hellen Cristina Souza de Carvalho Fusco
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marco Antônio Gonçalves Pontes Filho
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jorge Milhem Haddad
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Míriam Raquel Diniz Zanetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Amélia Pasqual Marques
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Elizabeth Alves Gonçalves Ferreira
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hellen Cristina Souza de Carvalho Fusco.

Ethics declarations

The Ethics Committee for Analysis of Research Projects - CAPPesq approved this study, under the number 40789914.1.0000.0065. All participants gave written informed consent before data collection began.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fusco, H.C.S.d., Pontes Filho, M.A.G., Haddad, J.M. et al. Lower urinary tract symptoms and perineal function in women with and without fibromyalgia: a cross-sectional study. Clin Rheumatol 38, 2885–2890 (2019). https://doi.org/10.1007/s10067-019-04617-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-019-04617-y

Keywords

Search

Navigation