Background Fibromyalgia (FM) is characterized by the American College of Rheumatology as chronic widespread pain referred for at least 3 months. In 2010, a new diagnostic criteria was proposed and includes symptoms such as fatigue, sleep disorder and memory. Currently, pelvic floor dysfunctions and urinary incontinence (UI) are considered public health problems with high prevalence and great impact on quality of life (QoL) and on women's self-esteem. Physiotherapists have been working to create a new treatment proposal that can cover all aspects of FM, however there are few studies that include pelvic floor evaluation and urinary continence of this population.
Objectives To assess the strength of the pelvic floor and urinary loss in women with FM.
Methods We evaluated 126 sexually active women, aged between 19 and 65 years, with and without medical diagnosis of FM, matched for age and menopausal status, in a single center. The exclusion criteria were sexually transmitted or neurological diseases, pregnancy and use of medications with urinary side effects (urinary loss or retention). We collected in a single interview personal and gynecological data, applied the King Health Questionnaire (KHQ) for incontinent women and accomplished the evaluation of pelvic floor muscle strength according to the Oxford Classification Modified and perineometry. The participants signed the Informed Consent Form. We used for statistical analysis t test for independent variables and Mann-Whitney Test for the others.
Results The FM patients presented the weaker pelvic floor (p<0.001) and had lower values in perineometry (p=0.04) than control women. Regarding urinary loss, 64.5% reported UI against 26.6% of women without FM. In the KHQ evaluation, in General Health and Emotions domains, women with FM presented worse performance (p<0.001 and p=0.046, respectively).
Conclusions Urinary incontinence is a frequent finding in FM, and it could be related to the degree of strength of the pelvic floor muscles. This condition affects negatively QoL, especially with regard to emotions and general health.
Wolfe, et al. The American College of Rheumatology Preliminary Diagnistic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care & Research, v.2, n.5, pg. 600–610, 2010.
Jones, K. D. et al. Pelvic Floor and Urinary Distress in Women with Fibromyalgia. Pain Management Nursing, v. 16, n. 6, p. 834–840, Dec 2015.
Acknowledgements This study received funds from CAPES (Coordination for the Improvement of Higher Education Personnel - Government Research Agency) with scholarship to one of the co-authors.
Disclosure of Interest None declared