Prevalence and Impact of Pelvic Floor Symptoms in Performing Artists and Artistic Athletes: A Systematic Review With Meta-analysis
In brief
More than half of performing artists have urinary incontinence, 83% report performance impact
A systematic review of 19 studies found that 52% of performing artists and artistic athletes experience urinary incontinence and 79% report anal incontinence, while nearly half report dyspareunia. Up to 83% say these pelvic floor problems negatively affect their training or stage performance, highlighting a largely overlooked health issue in this population.
- Journal
- The Journal of orthopaedic and sports physical therapy (Q1)
- Published
- 1 August 2026
- Study design
- Systematic review of cohort studies
- Evidence level
- Level 2, Moderate (CEBM 2a)
- Authors
- Jessica Cohen Frydenberg, Katia Ferrar, Jodie Dakic, Ebonie Rio, Sue Mayes, Helena Frawley
- PMID
- 42538791
- DOI
- 10.2519/jospt.2025.13452
Why clinicians should know about it
- Picked for Urology (paper of the day, 2 August 2026).
Abstract
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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.