Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2026 Jan 22.
doi: 10.1007/s00192-025-06505-3. Online ahead of print.

Core Stability in Women With and Without Lower Urinary Tract Symptoms: The CORE-LUTS Study

Stacey Bennis  1 , Abhilasha Kumar  2 , Hannah V Chatwin  3 , Marian Acevedo-Alvarez  2 , Haemi Choi  2 , Michael Wesolowski  2 , Colleen M Fitzgerald  2
Affiliations

Core Stability in Women With and Without Lower Urinary Tract Symptoms: The CORE-LUTS Study

Stacey Bennis et al. Int Urogynecol J. .

Abstract

Introduction and hypothesis: Lower urinary tract symptoms (LUTS) are highly prevalent in women. Core instability and physical activity (PA) may be associated with LUTS. The study hypothesized that compared with healthy controls, women with LUTS would have differences in core stability scores, reduced PA levels, and LUTS symptom severity would correlate inversely with core stability.

Methods: This cross-sectional cohort study recruited women aged 18-70 with and without LUTS. Participants completed demographics, Urinary Distress Inventory Short Form (UDI-6), Godin Shephard Leisure Time Exercise Questionnaire (Godin), a novel Resistance Activity Questionnaire (RAQ), and Core Score testing. Summary statistics were provided overall and by LUTS diagnosis. Wilcoxon rank sum tests compared median aerobic physical activity (aPA)/resistance physical activity (rPA) between groups. Regression analyses estimated the effects of LUTS and UDI-6 severity on core stability.

Results: A total of 48 women with LUTS and 49 women without LUTS participated (mean age 46 ± 12, BMI 32 ± 8). Women with LUTS were older (mean, SD 51, 12 vs 43, 13, p < 0.01) with higher parity (2, 1 vs 1, 1, p < 0.01), and higher constipation (n, %: 10, 21 vs 3, 6, p = 0.03), dyspareunia (12, 25 vs 2, 4, p < 0.01), and current formal core exercise instruction (10, 21 vs 3, 6, p = 0.03). After adjusting for age, BMI, and parity, women with LUTS had lower Core Scores (mean difference; 95% CI -1.08; -1.99, -0.18, p < 0.01); PA levels did not differ on Godin (median, IQR 21.5, 10 to 39.5 vs 21, 11 to 46, p = 0.58) or RAQ (0, 0 to 6 vs 2, 0 to 6, p = 0.12), and UDI symptom severity increases of 10 units correlated inversely with Core Scores (mean effect, 95% CI -0.32, -0.53, -0.10, p < 0.01).

Conclusions: Women with LUTS had small, significantly worse core stability scores, but APA and rPA levels did not differ. LUTS severity was associated with worse core stability. Further research may help to determine association versus causation.

Keywords: Balance; Bladder health; Pelvic health; Strength.

PubMed Disclaimer

Conflict of interest statement

Declarations. Financial Disclosures/Conflicts of Interest: M.A.-A.: consultant for CooperSurgical. S.B.: co-investigator on NIH Grant titled Musculoskeletal and Pelvic Floor Health in Female Chronic Overlapping Pelvic Pain Conditions (The MSK-PELVIC Study); source of support: Eunice Kennedy Shriver National Institute of Child Health & Human Development; project award number: 1R21HD105115-01A1; Unique Federal Award Identification Number: R21HD105115; Date of Funding Period: 16 September 2022 to 31 August 2024. C.F.: NIH fundings, NIDDK, NICHD; UpToDate editor royalties; expert witness; speaker for Kaiser, UCSF. A.K., H.V.C., H.C., and M.W. have no financial disclosures or conflicts of interest. Patient Consent: All participants completed informed consent prior to study participation. Permission to Reproduce Material from Other Sources: Not applicable. Ethics of Approval: This study was approved by the Loyola University Medical Center/Loyola University Chicago Health Sciences Institutional Review Board (LU#214646). Clinical Trial Registration: Not applicable (this is a prospective cross-sectional cohort study, no interventions were utilized).

References

    1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167–78. - PubMed - DOI
    1. Boyle P, Robertson C, Mazzetta C, Keech M, Hobbs FD, Fourcade R, et al. The prevalence of lower urinary tract symptoms in men and women in four centres. The UrEpik study. BJU Int. 2003;92(4):409–14. - PubMed - DOI
    1. Coyne KS, Sexton CC, Thompson CL, Milsom I, Irwin D, Kopp ZS, et al. The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the epidemiology of LUTS (EpiLUTS) study. BJU Int. 2009;104(3):352–60. - PubMed - DOI
    1. Omae K, Yamamoto Y, Kurita N, Takeshima T, Naganuma T, Takahashi S, et al. Gait speed and overactive bladder in the healthy community-dwelling super elderly: the Sukagawa study. Neurourol Urodyn. 2019;38(8):2324–32. - PubMed - DOI
    1. Paquin MH, Duclos C, Lapierre N, Dubreucq L, Morin M, Meunier J, et al. The effects of a strong desire to void on gait for incontinent and continent older community-dwelling women at risk of falls. Neurourol Urodyn. 2020;39(2):642–9. - PubMed - DOI

LinkOut - more resources