Association of disability with urinary and sexual dysfunction in patients with multiple sclerosis

Document Type : Original Article

Authors

1 Instructor, Department of Nursing and Midwifery, Quchan Branch, Islamic Azad University, Quchan, Iran.

2 Professor, Department of Neurology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.

3 Neurologist, Zahedan University of Medical Sciences, Zahedan, Iran.

Abstract

Introduction: Multiple Sclerosis (MS) is one of the most common diseases of the central nervous system and is one of the causes of progressive disability in young people who may be sexually active. This disability can be associated with sexual-urinary problems that affect all aspects of their lives. This study was performed with aim to evaluate the association between disability and urinary-sexual dysfunction in women with MS.
Methods: This descriptive-correlation study was performed on 78 women with MS referred to Neurology clinic of Ghaem Hospital in 2013. Data collection tools included individual characteristics form with the questions related to urinary problems, Krutzke disability scale, and female sexual function index (FSFI). Data were analyzed by SPSS software (version 19) and descriptive and analytic statistics. P<0.05 was considered statistically significant.
Results: Patients had participated with mild (52.6%) and moderate (47.4%) disability. The highest and least frequency were satisfaction domain (43.6%) and sexual pain (10.3%), respectively. 30 patients (38.5%) had problems in more than three domains of sexual dysfunction. Regarding to the prevalence of urinary disorders, the highest and least frequency were urgency in urination (30%) and urinary incontinence (2.5%), respectively. Pearson’s correlation coefficient reported significant reverse relationship between disability level with sexual dysfunction (r=-0.61 P=0.001). Based on regression analysis, it was determined that disability level, high age, the years of diagnosing disease and the type of relapsing-remitting disease had the greatest effect on sexual dysfunction.
Conclusion: The incidence of urinary – sexual dysfunction in multiple sclerosis affects all aspects of life, so the evaluation of patients should focus more on these disorders and provide context for the implementation of rehabilitation programs for patients.

Keywords


  1. Fletcher SG, Castro-Borrero W, Remington G, Treadaway K, Lemack GE, Frohman EM. Sexual dysfunction in patients with multiple sclerosis: a multidisciplinary approach to evaluation and management. Nat Clin Pract Urol 2009; 6(2):96-107.
  2. Frohman EM, Racke MK, Raine CS. Multiple sclerosis--the plaque and its pathogenesis. N Engl J Med 2006; 354(9):942-55.
  3. World Health Organization. Atlas: multiple sclerosis resources in the world 2008. Geneva: World Health Organization; 2008.
  4. Motl RW, Snook EM. Physical activity, self-efficacy, and quality of life in multiple sclerosis. Ann Behav Med 2008; 35:111-5.
  5. Bronner G, Elran E, Golomb J, Korczyn AD. Female sexuality in multiple sclerosis: the multidimensional nature of the problem and the intervention. Acta Neurol Scand 2010; 121(5):289-301.
  6. Sevene A, Akrour B, Galimard-Maisonneuve E, Kutneh M, Royer P, Sevène M. Multiple sclerosis and sexuality: a complex model. Sexologies 2009; 18(2):86-90.
  7. Kessler TM, Fowler CJ, Panicker JN. Sexual dysfunction in multiple sclerosis. Expert Rev Neurother 2009; 9(3):341-50.
  8. Donze C, Hautecoeur P. Urinary, sexual, and bowel disorders in early-stage multiple sclerosis. Rev Neurol 2009; 165:S148-55.
  9. Celik DB, Poyraz EÇ, Bingöl A, İdiman E, Özakbaş S, Kaya D. Sexual dysfunction ın multiple sclerosis: gender differences. J Neurol Sci 2013; 324(1):17-20.
  10. Merghati-Khoei E, Qaderi K, Amini L, Korte JE. Sexual problems among women with multiple sclerosis. J Neurol Sci 2013; 331(1):81-5.
  11. Nortvedt MW, Riise T, Frugaård J, Mohn J, Bakke A, Skår A, et al. Prevalence of bladder, bowel and sexual problems among multiple sclerosis patients two to five years after diagnosis. Mult Scler 2007; 13(1):106-12.
  12. Hulter BM, Lundberg PO. Sexual function in women with advanced multiple sclerosis. J Neurol Neurosurg Psychiatry 1995; 59(1):83-6.
  13. Khan F, Ng L, Turner‐Stokes L. Effectiveness of vocational rehabilitation intervention on the return to work and employment of persons with multiple sclerosis. Cochrane Database Syst Rev 2009; 1:CD007256.
  14. Mohammadi K, Rahnama P, Moayed MS, Faghihzadeh S, Sahraian MA, Mohammaditabar S, et al. Sexual dysfunction and predisposing factors in women with multiple sclerosis. Payesh 2013; 12(1):71-7. (Persian).
  15. Nortvedt M, Riise T. The use of quality of life measures in multiple sclerosis research. Mult Scler 2003; 9(1):63-72.
  16. Pittock SJ, Mayr WT, McClelland RL, Jorgensen NW, Weigand SD, Noseworthy JH, et al. Quality of life is favorable for most patients with multiple sclerosis: a population-based cohort study. Arch Neurol 2004; 61(5):679-86.
  17. Selkirk SM, Shi J. Relapsing-remitting tumefactive multiple sclerosis. Mult Scler 2005; 11(6):731-4.
  18. Miller DH, Leary SM. Primary-progressive multiple sclerosis. Lancet Neurol 2007; 6(10):903-12.
  19. Kroencke DC, Lynch SG, Denney DR. Fatigue in multiple sclerosis: relationship to depression, disability, and disease pattern. Mult Scler 2000; 6(2):131-6.
  20. Bishop M, Frain MP. The multiple sclerosis self-management scale: revision and psychometric analysis. Rehabil Psychol 2011; 56(2):150-9.
  21. Bishop M, Frain MP, Rumrill PD, Rymond C. The relationship of self-management and disease modifying therapy use to employment status among adults with multiple sclerosis. J Vocat Rehabil 2009; 31(2):119-27.
  22. Gulick EE. Emotional distress and activities of daily living functioning in persons with multiple sclerosis. Nurs Res 2001; 50(3):147-54.
  23. Mitchell AJ, Benito-León J, Rivera-Navarro J, Morales-González JM. Quality of life is not favorable for most patients with multiple sclerosis. Arch Neurol 2004; 61(11):1807-8.
  24. Månsson E, Lexell J. Performance of activities of daily living in multiple sclerosis. Disabil Rehabil 2004; 26(10):576-85.