Prevalence of pelvic floor dysfunction in recreational athletes: a cross-sectional survey

Campbell, K Gillian; Batt, Mark E.; Drummond, Avril

Abstract

Introduction and hypothesis
Pelvic floor dysfunction (PFD) affects many women and participation in elite sport and high-impact exercise has been reported as a potential risk. However, few studies have investigated the effects of exercising at recreational levels on PFD. Our aim was to investigate levels of PFD in women exercising at, or above, UK guidelines for health and compare them with levels in non-exercisers.

Method
Data on levels of PFD and potential risk factors (age, hormonal status, body mass index, constipation, parity, forceps delivery, and recreational exercise) were collected using a cross-sectional survey distributed via social media. The International Consultation Incontinence Questionnaire (ICIQ) Urinary Incontinence Short Form was used to estimate prevalence of urinary incontinence (UI). Selected questions from the ICIQ vaginal symptom and bowel symptom questionnaires were used to estimate prevalence of anal incontinence (AI) and pelvic organ prolapse (POP). Logistic regression analysis was used to compare exercisers and non-exercisers after adjusting for potential confounders.

Results
We recruited 1,598 adult women (1,141 exercisers and 457 non-exercisers). The majority were parous. High prevalence of UI (70%), AI (52%) and POP (18%) was reported. No significant association was found between recreational exercise and PFD despite adjustment for confounders, or further investigation regarding exercise involving impact, although some increased reporting of AI was seen in those exercising for over 10 hours per week.

Conclusion
High levels of all PFD were reported but no significant association was found between recreational exercise and symptoms. However, data suggest that women modify their exercise regimes as required. Few symptomatic women sought professional help.

Citation

Campbell, K. G., Batt, M. E., & Drummond, A. (2023). Prevalence of pelvic floor dysfunction in recreational athletes: a cross-sectional survey. International Urogynecology Journal, https://doi.org/10.1007/s00192-023-05548-8

• Journal Article Type: Article
• Acceptance Date: Apr 7, 2023
• Online Publication Date: May 10, 2023
• Publication Date: May 10, 2023
• Deposit Date: May 12, 2023
• Journal: International Urogynecology Journal
• Print ISSN: 0937-3462
• Electronic ISSN: 1433-3023
• Publisher: Springer Science and Business Media LLC
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1007/s00192-023-05548-8
• Keywords: Female athlete · Pelvic floor · Incontinence · Pelvic organ prolapse · Prevalence
• Public URL: https://nottingham-repository.worktribe.com/output/20566204
• Publisher URL: https://link.springer.com/article/10.1007/s00192-023-05548-8
• Additional Information: Received: 10 February 2023; Accepted: 7 April 2023; First Online: 10 May 2023; : ; : This study was approved by the University of Nottingham, Faculty of Medicine and Health Sciences Research Ethics Committee FMHS 501–0322. All participants gave electronic consent before progressing to data collection. Data were anonymised at source and no individual IP addresses were retained.; : None.; : A summary of the data set generated and analysed during the current study may be available from the corresponding author on reasonable request.; : A patient representative, who has experienced pelvic floor dysfunction and its impact on her sport, was involved as a member of the study steering group from its inception and took an equal part in all aspects of design of the survey, study protocol and decisions regarding advertising and analysis. She will continue to be involved as a member of the steering group to decide on potential ways to disseminate the results to the public going forward. Further, local women were recruited to pilot initial versions of the survey to identify any issues with wording and content. The final version was modified based on their feedback.