Prevalence of pelvic floor dysfunction in male athletes and its dose-dependency in high-intensity exercise: A scoping review.

BACKGROUND

This scoping review summarises literature on the prevalence and types of male pelvic floor dysfunction linked to increasing exercise intensity, with a secondary aim of exploring whether a dose-dependent relationship exists between the two.

METHODS

A comprehensive search of CINAHL, PEDro, PubMed, Scopus, and Web of Science databases was conducted up to January 2025 using MeSH terms and keywords relating to exercise and PFD.

RESULTS

The search yielded 6031 publications with 1199 duplicates removed prior to screening. After screening 4493 articles, 10 articles were eligible for inclusion. Substantial reporting differences of exercise-related variables were identified. Six studies reported prevalence rates of lower urinary tract symptoms (LUTS), including urinary incontinence, ranging from 3.8 % to 18.8 %. Only one study examined multiple pelvic floor issues, identifying anorectal incontinence in 61.8 % of participants. Studies investigating erectile dysfunction (ED) and chronic prostatitis/pelvic pain (CP/CPPS) reported hazard and odds ratios. When reporting as ratios for ED, CP/CPPS, studies identified that higher weekly MET-minutes of physical activity were slightly more protective than sedentary or lower physical activity levels. The cross-sectional studies reporting LUTS as a sample percentage identified a dose-dependent relationship between weekly MET-minutes and the prevalence of male LUTS, based on both minimum and maximum weighted averages (R = 0.86 vs. R = 0.87).

CONCLUSIONS

Athletic males may experience higher rates of LUTS than the general population. A dose-dependent relationship between MET-minutes per week and male LUTS indicates that men who exercise intensely at higher volumes may be at greater risk of symptomology, whereas risk of ED and CP/CPPS may be reduced.