Physiotherapy interventions in improving urinary incontinence in patients with multiple sclerosis: a narrative review

Urinary incontinence is very common in multiple sclerosis patients, which affects various aspects of relationships and quality of life. The aim of this narrative review is to collect approved methods of physiotherapy treatments which are effective in healing urinary incontinence in these patients.

In this study, investigations conducted from 1997 to 2023 regarding urinary incontinence physiotherapy for patients with multiple sclerosis were reviewed. A search was made in different databases of Google Scholar, PubMed and Science Direct for retrieving English articles using the keywords urinary incontinence, rehabilitation, physiotherapy, multiple sclerosis. Out of 40 retrieved articles, 23 articles were reviewed that properly considered the design, evaluation of the results and complications of the treatment and the existence of the control group.

The review of various studies showed that the strengthening and electrical stimulation of the pelvic floor muscles, the use of biofeedback electromyography, sacral magnetic stimulation and transcranial magnetic stimulation, skin stimulation of the posterior tibial nerve are effective treatments without side effects for patients with multiple sclerosis.

Physiotherapy with different exercise methods and electrotherapy heal urinary incontinence and improve quality of life in multiple sclerosis patients, and the combination of treatments has a greater effect.