Pelvic Floor Dysfunction and Associated Factors in Women with Systemic Autoimmune Rheumatic Diseases: A Cross-Sectional Study.

Introduction and hypothesis: Systemic autoimmune rheumatic diseases (SARDs) cause musculoskeletal disorders and are associated with various issues that affect the quality of life. Since the musculoskeletal system is affected, the pelvic floor muscles can also be impacted, leading to possible pelvic floor dysfunctions (PFDs). Thus, the purpose of this study was to investigate the presence of PFDs, such as urinary incontinence (UI), anal incontinence (AI), genital-pelvic pain/penetration disorder (GPPPD), and pelvic organ prolapse (POP) symptoms in women with SARDs compared to a control group composed of women without SARDs; and investigate the association between SARDs and PFDs.

Methods: An online cross-sectional survey was carried out. Using a web-based questionnaire, data on demographic and anthropometric features, PFD (UI, nocturia, AI, GPPPD, and POP), and obstetric history were gathered. For quantitative variables, the Mann-Whitney U test was used, and for categorical variables, the chi-squared test was used for comparison between groups. The association between SARDs and PFD was investigated using logistic regression analysis.

Results: The questionnaire was completed by 326 women (224 with SARDs and 102 healthy controls). Women with SARDs reported significantly more symptoms of PFD, UI, nocturia, AI (flatus and fecal incontinence), POP, and GPPPD than healthy controls. SARDs were associated with PFD, flatus incontinence, fecal incontinence, dyspareunia, and vaginismus.

Conclusions: PFD was much more common in women with SARDs than in healthy women. Women with SARDs were 1.8 to 5.2 times more likely than the control group to report PFD symptoms than women without SARDs.