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

  • Hellen Cristina Souza de Carvalho FuscoEmail author
  • Marco Antônio Gonçalves Pontes Filho
  • Jorge Milhem Haddad
  • Míriam Raquel Diniz Zanetti
  • Amélia Pasqual Marques
  • Elizabeth Alves Gonçalves Ferreira
Original Article


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.


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).


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.


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


Fibromyalgia Pelvic floor Quality of life Urinary incontinence 



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).

Compliance with ethical standards

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.


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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  • Hellen Cristina Souza de Carvalho Fusco
    • 1
    Email author
  • Marco Antônio Gonçalves Pontes Filho
    • 2
  • Jorge Milhem Haddad
    • 3
  • Míriam Raquel Diniz Zanetti
    • 4
  • Amélia Pasqual Marques
    • 1
  • Elizabeth Alves Gonçalves Ferreira
    • 1
  1. 1.Department of Physiotherapy, Speech Therapy and Occupational Therapy, Faculty of MedicineUniversity of São PauloCidade UniversitáriaBrazil
  2. 2.Department of Rheumatology, Hospital das Clínicas, Faculty of MedicineUniversity of São PauloSão PauloBrazil
  3. 3.Department of Obstetrics and Gynecology, Faculty of MedicineUniversity of São PauloSão PauloBrazil
  4. 4.Department of Human Movement SciencesFederal University of São Paulo (UNIFESP)São PauloBrazil

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