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

OBJECTIVE: 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 JBI Critical Appraisal Checklists and the certainty of evidence was judged using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) 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 synthesised pelvic floor symptoms and impact data that were not included in the meta-analysis. RESULTS: Nineteen articles were included. Half (52%; 95% CI 38, 66%; I 2 92.7%) of performing artists and artistic athletes reported urinary incontinence, 79% (95% CI 69, 88%; I 2 80.6) reported anal incontinence, and 47% (95% CI 41, 53%; I 2 NR) reported dyspareunia. The discipline most affected by any type of urinary incontinence was trampolining (87%, 95% CI 70, 98%; I 2 NR). Up to 83% of performing artists and artistic athletes reported some negative impact from their symptoms. CONCLUSION: At least half of performing artists and artistic athletes reported pelvic floor symptoms, particularly urinary and flatal incontinence. The symptoms negatively impacted 83% of athletes during performance.