Younger Age Is Associated With Pelvic Floor Muscle Dysfunction in Women With Urinary Symptoms.

Importance: Recent articles have highlighted the existence of pelvic floor myofascial dysfunction in women presenting with pelvic floor disorders.

Objective: The aim of the study was to evaluate whether younger age is associated with pelvic floor muscle dysfunction in women with lower urinary tract symptoms, including urinary urgency, frequency, nocturia, and urinary incontinence.

Study Design: This retrospective cohort study included women seeking an initial outpatient urogynecology evaluation for urinary symptoms from 8/2018 to 2/2022. The primary outcome was the presence of pelvic floor muscle dysfunction, defined as a diagnosis of levator myalgia/spasm. Multivariable logistic regression was used to evaluate the association.

Results: Four hundred twenty-one women with lower urinary tract symptoms were included, and 115 (27.3%) were diagnosed with pelvic floor muscle dysfunction. Women with pelvic floor dysfunction were 13 years younger, less likely to report any incontinence (60% vs 71.9%, P = 0.026) and urgency incontinence (8.7% vs 17.3%, P = 0.04). There was no difference in reported urgency, frequency, or nocturia. Women with pelvic floor dysfunction were more likely to report dysuria (19.1% vs 9.5%, P = 0.012), dyspareunia (39% vs 7.5%, P < 0.001), vulvodynia (11.3% vs 2.3%, P < 0.001), and pelvic pain (25.2% vs 7.2%, P < 0.001). The odds of pelvic floor muscle dysfunction in women <40 years old was 2.34 times greater than women ≥40 years old, after adjusting for other factors (adjusted odds ratio 2.341, 95% confidence interval [1.102, 4.972]).

Conclusions: Younger women with lower urinary tract symptoms were significantly more likely to have pelvic floor muscle dysfunction compared to older women with similar symptoms, even after controlling for other associated characteristics.