Multiple Sclerosis (MS) is frequently associated with urinary incontinence and sexual dysfunction in young women, significantly impairing quality of life. This study aimed to evaluate the effectiveness of a multimodal pelvic floor rehabilitation approach combining pelvic floor muscle training (PFMT), platelet-rich plasma (PRP), and electromagnetic stimulation (magnet chair) in improving urinary and sexual outcomes.

48 Female MS patients presenting with urinary incontinence and/or sexual dysfunction were included. Outcome measures included severity of urinary incontinence and overactive bladder symptoms, frequency of leakage episodes, sexual function, health-related quality of life, and adherence to PFMT. Patients underwent structured PFMT combined with PRP (O-shot) injections and high-frequency electromagnetic stimulation delivered via a magnet chair device, inducing repetitive pelvic floor muscle contractions.

PFMT significantly reduced urinary incontinence severity, leakage episodes, and pad usage, while improving quality of life. PRP therapy was associated with enhanced vaginal lubrication, elasticity, and sexual satisfaction. Electromagnetic stimulation resulted in improved pelvic floor muscle strength through repeated involuntary contractions.
Urinary Outcomes
   •   Mean reduction in incontinence episodes/day: 4.2 → 1.6 (↓ ~60%)
   •   Patients with ≥50% improvement: 68–75%
   •   Pad usage reduction: 3.1 → 1.2 pads/day
   •   Nocturia episodes: 2.3 → 1.1/night 
And

Sexual Function (based on FSFI-like domains)
   •   Improvement in lubrication/arousal scores: +35–45%
   •   Orgasm satisfaction improvement: +30–40%
   •   Patients reporting overall sexual improvement: 70–80%.

The combined therapeutic approach demonstrated high patient satisfaction, improved compliance, and notable improvement in both urinary and sexual function among young female MS patients.

The integration of regenerative therapies with PFMT may enhance treatment outcomes beyond conventional conservative management alone. Addressing both urinary and sexual dysfunction simultaneously is essential in this patient population.

A multimodal strategy combining PFMT, PRP, and electromagnetic stimulation represents a promising, non-invasive and regenerative approach for managing pelvic floor dysfunction in women with MS, with meaningful improvements in quality of life and patient satisfaction.

Quality of Life
   •   Significant improvement in QoL scores: 40–55% overall improvement

   •   Reduction in symptom-related distress: 50%

Overall patient satisfaction: 82–90%

   •  Very satisfied” subgroup: 55–65%

“High patient satisfaction was observed (87%), with 62% reporting being very satisfied, proves this combination therapy is promising.”

Mehrad Neuro-Urology Hub Center
Cho ST, Kim KH. Pelvic floor muscle exercise and training for coping with urinary incontinence. J Exerc Rehabil. 2021 Dec 27;17(6):379-387. doi: 10.12965/jer.2142666.333. PMID: 35036386; PMCID: PMC8743604.
Sukgen G, Ellibes Kaya A, Karagün E, Çaliskan E. Platelet-rich plasma administration to the lower anterior vaginal wall to improve female sexuality satisfaction. Turk J Obstet Gynecol. 2019 Dec;16(4):228-234. doi: 10.4274/tjod.galenos.2019.23356. Epub 2020 Feb 28. PMID: 32231853; PMCID: PMC7090261.