Prevalence and Impact of Pelvic Floor Symptoms in Performing Artists and Artistic Athletes: A Systematic Review With Meta-analysis.

OBJECTIVES

To (1) estimate the prevalence of pelvic floor symptoms in performing artists and artistic athletes and (2) quantify the impact of symptoms during and outside performance and training.

DESIGN

Epidemiology systematic review with meta-analysis. LITERATURE SEARCH: Six databases were searched from inception to February 2025. STUDY SELECTION CRITERIA: Studies involving participants from any artistic discipline and with data on pelvic floor symptom or disorder prevalence or impact were included. DATA SYNTHESIS: Critical appraisal was conducted using the JBI (Joanna Briggs Institute) Critical Appraisal Checklist, and the certainty of evidence was judged using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. Data were pooled for pelvic floor symptom proportions in performing artists and artistic athletes, with subgroup analyses for any type of urinary incontinence by discipline. We descriptively synthesized pelvic floor symptoms and impact data that were not included in the meta-analysis.

RESULTS

Nineteen articles were included. Half (52%; 95% confidence interval [CI]: 38%, 66%; I2 = 92.7%) of the performing artists and artistic athletes reported urinary incontinence, 79% (95% CI: 69%, 88%; I2 = 80.6%) reported anal incontinence, and 47% (95% CI: 41%, 53%; I2 = not reported (NR)) reported dyspareunia. The discipline most affected by any type of urinary incontinence was trampolining (87%; 95% CI: 70%, 98%; I2 = NR). Up to 83% of the performing artists and artistic athletes reported some negative impact from their symptoms.

CONCLUSION

At least half of the performing artists and artistic athletes reported pelvic floor symptoms, particularly urinary and flatal incontinence. The symptoms negatively impacted 83% of the athletes during performance. J Orthop Sports Phys Ther 2026;56(8):530-545. Epub September 19 2025. doi:10.2519/jospt.2025.13452.