Investigation of the Relationship of Urinary Incontinence Symptoms with Activities of Daily Living in Individuals with Multiple Sclerosis

Yıl 2024, Cilt: 8 Sayı: 3, 376 - 382

Anil Tosun , Ezgi Eryıldız , Ayça Aklar , Dilber Karagözoğlu Coşkunsu , Nergis Yılmaz

https://doi.org/10.46332/aemj.1445861

Öz

Purpose: Urinary incontinence (UI) is a common symptom for people with Multiple Sclerosis (MS) that negatively impacts daily activities. This study aimed to investigate the relationship between UI symptoms and the ability to perform daily activities in individuals diagnosed with MS.

Materials and Methods: The study included 45 participants diagnosed with MS and UI, with a mean age of 42.06±1.42. Participant data were collected through an online platform, Google Forms. The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) was used to assess UI symptoms, while the Incontinence Impact Questionnaire (IIQ-7) was used to evaluate the impact on daily life activities. Spearman correlation analysis was performed to assess the relationship between the ICIQ-SF and IIQ-7 subscales (physical activity, social activity, social relationships, and emotional health) and the total score.

Results: 26.7% of the participants urinated more than 8 times a day. The proportion of individuals who were unaware of bladder diaries was 75.6%, and 44.4% had difficulty initiating urination. A strong correlation was found between the ICIQ-SF and IIQ-7 physical activity, social activity subscales, and total score (rho=0.64, p<0.001; rho=0.53, p<0.001; rho=0.56, p<0.001). A moderate correlation was found between the social relationships and emotional health subscales (rho=0.45, p=0.002; rho=0.38, p=0.009).

Conclusion: Considering the negative impact of UI symptoms on the daily activities of individuals with MS, it is important to conduct a comprehensive assessment of UI and include individuals with MS in a tailored rehabilitation program based on the severity, type, and frequency of UI.

Anahtar Kelimeler

daily tasks, neurological disorder, urinary dysfunction

Etik Beyan

The present study was a cross-sectional study that was approved by the local Ethics Committee (Project no: 21.2022fbu) and conducted according to the Helsinki Declaration. Informed consent was obtained from all participants.

Üriner İnkontinans Semptomlarının Multipl Sklerozlu Bireylerde Günlük Yaşam Aktiviteleri ile İlişkisinin Araştırılması

Öz

Amaç: Üriner inkontinans (Üİ), Multipl Skleroz (MS) hastalarında yaygın görülen ve günlük aktiviteleri olumsuz etkileyen bir semptomdur. Bu çalışmada MS tanılı bireylerde Üİ şikayetleri ile günlük yaşam aktivitelerini gerçekleştirme becerisi arasındaki ilişkinin araştırılması amaçlanmıştır.

Araçlar ve Yöntem: Çalışmaya MS tanılı ve Üİ’ye sahip, yaş ortalaması 42.06±1.42 olan 45 katılımcı dahil edildi. Katılımcı verileri çevrimiçi bir platform olan Google Forms aracılığıyla toplandı. Uluslararası İdrar Kaçırma Konsültasyon Sorgulaması-Kısa Form (ICIQ-SF) Üİ şikayetlerini, İnkontinans Etki Sorgulaması (IIQ-7) anketi ise günlük yaşam aktiviteleri üzerindeki etkiyi değerlendirmek için kullanıldı. ICIQ-SF ile IIQ-7 fiziksel aktivite, sosyal aktivite, sosyal ilişkiler ve duygusal sağlık alt skorları ve total skoru arasındaki ilişkiyi değerlendirmek için Spearman korelasyon analizi yapıldı.

Bulgular: Katılımcıların %26.7'si günde 8 kereden fazla idrara çıkmaktaydı. Mesane günlüğü hakkında bilgi sahibi olmayan bireylerin oranı %75.6 ve işemeye başlamakta zorluk çekenlerin oranı ise %44.4'tü. ICIQ-SF ile IIQ-7 fiziksel aktivite ve sosyal aktivite alt boyutları ile total skoru arasında güçlü ilişki bulurken (sırasıyla rho=0.64, p<0.001; rho=0.53, p<0.001; rho=0.56, p<0.001), sosyal ilişkiler ve duygusal sağlık alt boyutları arasında orta derecede ilişki bulundu (sırasıyla rho=0.45, p=0.002; rho=0.38, p=0.009).

Sonuç: Üİ semptomlarının MS'li bireylerin günlük aktiviteleri üzerindeki olumsuz etkileri göz önüne alındığında, Üİ için kapsamlı bir değerlendirme yapılarak MS’lilerin, Üİ’nin şiddetine, tipine ve sıklığına göre uyarlanmış bir rehabilitasyon programına dahil edilmesi önemlidir.

Anahtar Kelimeler

üriner disfonksiyon, nörolojik bozukluk, aktivite

Kaynakça

• 1. Haki M, Al-Biati HA, Al-Tameemi ZS, Ali IS, Al-Hussaniy HA. Review of multiple sclerosis: Epidemiology, etiology, pathophysiology, and treatment. Medicine (Baltimore). 2024;103(8):e37297.
• 2. Kodosaki E, Watkins WJ, Loveless S, et al. Combination protein biomarkers predict multiple sclerosis diagnosis and outcomes. J Neuroinflammation. 2024;21 (1):52.
• 3. Belbasis L, Bellou V, Evangelou E, Ioannidis JP, Tzoulaki I. Environmental risk factors and multiple sclerosis: an umbrella review of systematic reviews and meta-analyses. Lancet Neurol. 2015;14(3):263-273.
• 4. Amatya B, Khan F, Galea M. Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2019;1(1): CD012732.
• 5. Zecca C, Riccitelli GC, Disanto G, et al. Urinary incontinence in multiple sclerosis: prevalence, severity and impact on patients' quality of life. Eur J Neurol. 2016;23(7):1228-1234.
• 6. Mubaraki AA, Alnemari MA, Aljuaid SO, Altalhi FM, Alamri YM, Altowairqi SO. The Prevalence and Impact of Urinary Incontinence on Multiple Sclerosis Patients in Taif City, Saudi Arabia. Cureus. 2024;16(3): e57010.
• 7. Irwin GM. Urinary Incontinence. Prim Care. 2019;46(2):233-242.
• 8. Leslie SW, Tran LN, Puckett Y. Urinary Incontinence. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 11, 2024.
• 9. Mohamed-Ahmed R, Taithongchai A, da Silva AS, Robinson D, Cardozo L. Treating and Managing Urinary Incontinence: Evolving and Potential Multicomponent Medical and Lifestyle Interventions. Res Rep Urol. 2023;15(2023):193-203.
• 10. Farrés-Godayol P, Jerez-Roig J, Minobes-Molina E, et al. Urinary Incontinence and Its Association with Physical and Psycho-Cognitive Factors: A Cross-Sectional Study in Older People Living in Nursing Homes. Int J Environ Res Public Health. 2022;19(3): 1500.
• 11. Boylu İ, Dağlar, G. Kadınlarda üriner inkontinans ve damgalanma.Cumhuriyet univ sağlık bilim. enst.derg. 2020;5(2):109-114.
• 12. Kadıoğlu M, Kızılkaya Beji N. Üriner İnkontinans Tedavisinde Önerilen Yaşam Biçimi Uygulamalarına Güncel Yaklaşım. HSP. 2016;3(3):201-207.
• 13. Abu Raddaha AH, Nasr EH. Kegel Exercise Training Program among Women with Urinary Incontinence. Healthcare (Basel). 2022;10(12):2359.
• 14. Jacob L, Tanislav C, Kostev K. Multiple Sclerosis and Incidence of Urinary and Fecal Incontinence in Almost 9,000 Patients Followed Up for up to 10 Years in Germany. Neuroepidemiology. 2021;55(2):92-99.
• 15. Eyigor S, Karapolat H, Akkoc Y, Yesil H, Ekmekci O. Multipl sklerozlu ve üriner bozuklukları olan hastalarda yaşam kalitesi: İnkontinans Yaşam Kalitesi Ölçeği'nin Türkçe versiyonunun güvenilirliği ve geçerliliği. J Rehabil Res Dev. 2010;47(1):67-71.
• 16. Çetinel B, Özkan B, Can G. ICIQ-SF Türkçe versiyonunun geçerlilik çalışması. Turk. J. Urol. 2004; 30(3):332-338.
• 17. Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn. 2004;23(4):322-330.
• 18. Cam C, Sakalli M, Ay P, Cam M, Karateke A. Validation of the short forms of the incontinence impact questionnaire (IIQ-7) and the urogenital distress inventory (UDI-6) in a Turkish population. Neurourol Urodyn. 2007;26(1):129-133.
• 19. Åström Y, Asklund I, Lindam A, Sjöström M. Quality of life in women with urinary incontinence seeking care using e-health. BMC Womens Health. 2021;21(1):337.
• 20. Zecca, C., Riccitelli, G. C., Disanto, et al. Urinary incontinence in multiple sclerosis: prevalence, severity and impact on patients' quality of life. Eur. J. Neurol. 2016;23(7):1228-1234.
• 21. Abakay H, Doğan H, Yetkin MF, Güç A, Talay Çaliş H, Demir Çaltekin M. The effects of incontinence on functionality, disability, and quality of life in male and female patients with multiple sclerosis. Mult Scler Relat Disord. 2022;66:104010.
• 22. Lúcio AC, Perissinoto MC, Natalin RA, Prudente A, Damasceno BP, D'ancona CA. A comparative study of pelvic floor muscle training in women with multiple sclerosis: its impact on lower urinary tract symptoms and quality of life. Clinics (Sao Paulo). 2011;66(9): 1563-1568.
• 23. Ysrraelit MC, Correale J. Impact of sex hormones on immune function and multiple sclerosis development. Immunology. 2019;156(1):9-22.
• 24. Frigerio M, Barba M, Cola A, et al. Quality of Life, Psychological Wellbeing, and Sexuality in Women with Urinary Incontinence-Where Are We Now: A Narrative Review. Medicina (Kaunas). 2022;58(4):525.
• 25. Aoki Y, Brown HW, Brubaker L, Cornu JN, Daly JO, Cartwright R. Urinary incontinence in women. Nat Rev Dis Primers. 2017;3(1):1-20.
• 26. Li M, Chen H, Yin P, et al. Identification and Clinical Validation of Key Extracellular Proteins as the Potential Biomarkers in Relapsing-Remitting Multiple Sclerosis. Front Immunol. 2021;12:753929.
• 27. Nambiar AK, Arlandis S, Bø K, et al. European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 1: Diagnostics, Overactive Bladder, Stress Urinary Incontinence, and Mixed Urinary Incontinence. Eur Urol. 2022;82(1):49-59.
• 28. Abrams P, Andersson KE, Apostolidis A, et al. 6th International Consultation on Incontinence. Recommendations of the International Scientific Committee: Evaluatıon And Treatment Of Urınary Incontınence, Pelvıc Organ Prolapse And Faecal Incontınence. Neurourol Urodyn. 2018;37(7):2271-2272.
• 29. Vecchio, M., Chiaramonte, R., & DI Benedetto, P. Management of bladder dysfunction in multiple sclerosis: a systematic review and meta-analysis of studies regarding bladder rehabilitation. Eur J Phys Rehabil Med. 2022;58(3):387-396.
• 30. Menoux D, Chesnel C, Charlanes A, et al. Reproductibilité du calendrier mictionnel chez les patients atteints de sclérose en plaques. Étude prospective monocentrique [Reproducibility of bladder diary in patients with multiple sclerosis]. Prog Urol. 2018;28(7):387-395.
• 31. Hansson Vikström, N., Wasteson, E., Lindam, A., & Samuelsson, E. Anxiety and depression in women with urinary incontinence using E-health. IUJ. 2021;32(1):103-109.
• 32. Kayalı Demir N, Yılmaz T. Menopoz Döneminde Olan Kadınlarda Üriner İnkontinans. Kashed. Kasım 2022;8(3):169-178.
• 33. Kannan P, Hsu WH, Suen WT, Chan LM, Assor A, Ho CM. Yoga and Pilates compared to pelvic floor muscle training for urinary incontinence in elderly women: A randomised controlled pilot trial. Complement Ther Clin Pract. 2022;46:101502.
• 34. Lee HY, Rhee Y, Choi KS. Urinary incontinence and the association with depression, stress, and self-esteem in older Korean Women. Sci Rep. 2021;11(1):9054.
• 35. Joseph C, Srivastava K, Ochuba O, et al. Stress Urinary Incontinence Among Young Nulliparous Female Athletes. Cureus. 2021;13(9):e17986.