Prevalence of co-existing pelvic floor disorders: A scoping review in males and females

Introduction: Dysfunction of the pelvic floor may lead to pelvic floor symptoms within different domains simultaneously, such as lower urinary tract symptoms (LUTS), bowel symptoms, pelvic organ prolapse, sexual problems and genito-pelvic pain. The aim of this scoping review is to provide an overview of the prevalence of concomitant pelvic floor symptoms, and the associated risk factors, in the general male and female population, and to identify knowledge gaps. Methods: A literature search was conducted in the electronic database PubMed to identify relevant articles published in English. Articles were eligible when at least two different pelvic floor symptom domains were mentioned, or one type of pelvic floor symptom was mentioned as a risk factor for another pelvic floor symptom, and when the study was conducted in the general adult population or in the primary care setting. Results: In total 91 articles were selected, describing data from 73 different (cohort) studies. Twenty articles were found describing concomitant pelvic floor symptoms in both sexes, predominantly assessing double incontinence (DI). Twenty-six articles were found in male (sub)populations, of which 25 articles described the co -occurrence of sexual problems with another type of pelvic floor symptom. Concomitant LUTS and erectile dysfunction was common with prevalence estimates ranging from 14%-61%. Prevalence of DI in male populations ranged between 1%-14%. Forty-five articles were found in female (sub)populations. Most articles described DI, with prevalence rates ranging between 4%-15%. About a quarter to one third of females had one or more pelvic floor symptoms (i.e. urinary incontinence, fecal incontinence, pelvic organ prolapse) and around 1% had two or three of the above mentioned pelvic floor symptoms. Conclusion: For males, there is limited information on concomitant pelvic floor symptoms, especially including bowel symptoms and pelvic pain. When bowel symptoms are assessed, this is done predominantly in studies assessing DI. In the female population, pelvic pain and sexual dysfunction are rarely studied. In general, less research is performed in the male population than in the female population.