Pelvic Floor Muscle Evaluation in Older Women with Urinary Incontinence: A Feasibility Study.

Abstract

Introduction and hypothesis: The objective of this feasibility study was to characterize the pelvic floor muscles (PFMs) in older women with urinary incontinence (UI) via clinical and magnetic resonance imaging (MRI) evaluation.

Methods: This cross-sectional study included women aged ≥ 70 years with symptomatic UI confirmed by a 3-day bladder diary. Clinical evaluation of the PFMs included the Modified Oxford Scale strength assessment (grade 0-5). PFM defects were also characterized as none/normal, minor, and major based on MRI evaluation. Descriptive statistics were utilized. Spearman's correlation with 95% confidence intervals was calculated between PFMs strength, MRI defects, and age.

Results: Participants (n = 20) were 76.6 ± 4.7 years. Clinical evaluation demonstrated poor PFM strength in 95% (n = 19) of participants with the following grades: 15% (n = 3) grade 0, 45% (n = 9) grade 1, and 35% (n = 7) grade 2. MRI evaluation demonstrated PFMs= defects in 100% of participants with 45% (n = 9) minor and 55% (n = 11) major defects. The correlation coefficients between PFM strength and MRI defects, MRI defects and age, and PFM strength and age were -0.29 (95% CI -0.64, 0.18; p = 0.22), -0.01 (95% CI = -0.44, 0.44; p = 0.99), and 0.04 (95% CI = -0.41, 0.47; p = 0.88) respectively.

Conclusion: Clinical and MRI evaluation of PFMs in older women with UI is feasible. Clinical evaluation of PFMs demonstrated poor strength in 95% of women, and MRI revealed PFM defects in all participants.