Association between lower urinary tract symptoms on quality of life in women with multiple sclerosis: The mediating role of loneliness.

PURPOSE: The objective of this study is to investigate the associationbetween lower urinary tract symptoms (LUTS) and social isolation,loneliness, and quality of life in female patients with multiple sclerosis(MS). METHODS: This cross-sectional study included 170 female multiplesclerosis patients meeting inclusion criteria from a university hospitalneurology clinic. Using standardized instruments (Bristol FLUTS, I-QOL,Social Isolation and Loneliness Scales), data were collected via face-to-faceinterviews (December 2022-June 2023). RESULTS: The mean age of the 170 female patients with MS included in thestudy was 40.4 years (±12.4 SD). Evaluation using the Bristol FemaleLower Urinary Tract Symptoms Scale yielded a mean total score of 20.77(±12.4). The analysis revealed that 92.9% of patients experienced urinaryincontinence, with urgency-type incontinence being particularly prevalent(84.1%). Path analysis results demonstrated that increased severity ofurinary symptoms was significantly associated with elevated levels ofsocial isolation (β=0.122, p<0.001), greater loneliness (β=0.126,p<0.001), and reduced quality of life (β=-1.003, p<0.001). Mediationanalysis revealed a significant indirect association between lower urinarytract symptoms and quality of life through loneliness (p=0.018). CONCLUSION: This study highlights that urinary symptoms in women with multiple sclerosis are significantly associated with quality of life, social isolation, and loneliness. The analysis suggests that loneliness plays a significant mediating role in the association between lower urinary tract symptoms and quality of life. These findings imply that addressing psychosocial factors, particularly loneliness, alongside clinical management of urinary symptoms, may be relevant for supporting overall well-being in this patient population.