{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:59:07Z","timestamp":1787061547487,"version":"build-2736575974"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T00:00:00Z","timestamp":1683676800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T00:00:00Z","timestamp":1683676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["ICA Post-doctoral Bridging award no number"],"award-info":[{"award-number":["ICA Post-doctoral Bridging award no number"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and hypothesis<\/jats:title>\n                    <jats:p>Pelvic floor dysfunction (PFD) affects many women and participation in elite sport and high-impact exercise has been reported as a potential risk. However, few studies have investigated the effects of exercising at recreational levels on PFD. Our aim was to investigate levels of PFD in women exercising at, or above, UK guidelines for health and compare them with levels in non-exercisers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Data on levels of PFD and potential risk factors (age, hormonal status, body mass index, constipation, parity, forceps delivery, and recreational exercise) were collected using a cross-sectional survey distributed via social media. The International Consultation Incontinence Questionnaire (ICIQ) Urinary Incontinence Short Form was used to estimate prevalence of urinary incontinence (UI). Selected questions from the ICIQ vaginal symptom and bowel symptom questionnaires were used to estimate prevalence of anal incontinence (AI) and pelvic organ prolapse (POP). Logistic regression analysis was used to compare exercisers and non-exercisers after adjusting for potential confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We recruited 1,598 adult women (1,141 exercisers and 457 non-exercisers). The majority were parous. High prevalence of UI (70%), AI (52%) and POP (18%) was reported. No significant association was found between recreational exercise and PFD despite adjustment for confounders, or further investigation regarding exercise involving impact, although some increased reporting of AI was seen in those exercising for\u2009over 10\u00a0hours\u00a0per week.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>High levels of all PFD were reported but no significant association was found between recreational exercise and symptoms. However, data suggest that women modify their exercise regimes as required. Few symptomatic women sought professional help.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00192-023-05548-8","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T02:57:24Z","timestamp":1683773844000},"page":"2429-2437","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Prevalence of pelvic floor dysfunction in recreational athletes: a cross-sectional survey"],"prefix":"10.1007","volume":"34","author":[{"given":"K. Gillian","family":"Campbell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark E.","family":"Batt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avril","family":"Drummond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,5,10]]},"reference":[{"key":"5548_CR1","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/s00192-009-0976-9","volume":"21","author":"BT Haylen","year":"2010","unstructured":"Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)\/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21:5\u201326. https:\/\/doi.org\/10.1007\/s00192-009-0976-9.","journal-title":"Int Urogynecol J"},{"issue":"8","key":"5548_CR2","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1002\/nau.20709","volume":"28","author":"M Nilsson","year":"2009","unstructured":"Nilsson M, Lalos A, Lalos O. The impact of female urinary incontinence and urgency on quality of life and partner relationship. Neurourol Urodyn. 2009;28(8):976\u201381. https:\/\/doi.org\/10.1002\/nau.20709.","journal-title":"Neurourol Urodyn"},{"issue":"11","key":"5548_CR3","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1001\/jama.300.11.1311","volume":"300","author":"I Nygaard","year":"2008","unstructured":"Nygaard I, Barber MD, Burgio KL, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008;300(11):1311\u20136. https:\/\/doi.org\/10.1001\/jama.300.11.1311.","journal-title":"JAMA"},{"issue":"2","key":"5548_CR4","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.ajog.2005.07.051","volume":"194","author":"KN Danforth","year":"2006","unstructured":"Danforth KN, Townsend MK, Lifford K, Curhan GC, Resnick NM, Grodstein F. Risk factors for urinary incontinence among middle-aged women. Am J Obstet Gynecol. 2006;194(2):339\u201345. https:\/\/doi.org\/10.1016\/j.ajog.2005.07.051.","journal-title":"Am J Obstet Gynecol"},{"issue":"12","key":"5548_CR5","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.1007\/s00192-018-3651-1","volume":"29","author":"RV Teixeira","year":"2018","unstructured":"Teixeira RV, Colla C, Sbruzzi G, Mallmann A, Paiva LL. Prevalence of urinary incontinence in female athletes: a systematic review with meta-analysis. Int Urogynecol J. 2018;29(12):1717\u201325. https:\/\/doi.org\/10.1007\/s00192-018-3651-1.","journal-title":"Int Urogynecol J"},{"issue":"5","key":"5548_CR6","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1089\/jwh.2010.2454","volume":"20","author":"V Vitton","year":"2011","unstructured":"Vitton V, Baumstarck-Barrau K, Brardjanian S, Caballe I, Bouvier M, Grimaud JC. Impact of high-level sport practice on anal incontinence in a healthy young female population. J Womens Health. 2011;20(5):757\u201363. https:\/\/doi.org\/10.1089\/jwh.2010.2454.","journal-title":"J Womens Health"},{"issue":"2","key":"5548_CR7","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.amjmed.2015.07.016","volume":"129","author":"SF Lewis","year":"2016","unstructured":"Lewis SF, Hennekens CH. Regular physical activity: forgotten benefits. Am J Med. 2016;129(2):137\u20138. https:\/\/doi.org\/10.1016\/j.amjmed.2015.07.016.","journal-title":"Am J Med"},{"issue":"6","key":"5548_CR8","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1503\/cmaj.051351","volume":"174","author":"DER Warburton","year":"2006","unstructured":"Warburton DER, Nicol CW, Bredin SSD. Health benefits of physical activity: the evidence. Can Med Assoc J. 2006;174(6):801\u20139. https:\/\/doi.org\/10.1503\/cmaj.051351.","journal-title":"Can Med Assoc J"},{"key":"5548_CR9","unstructured":"Department of Health and Social Care. Physical activity guidelines: UK Chief Medical Officers\u2019 Report.\u00a0London: Department of Health and Social Care;\u00a02019. Available online: https:\/\/www.gov.uk\/government\/publications\/physical-activity-guidelines-uk-chief-medical-officers-report. Accessed\u00a015 Mar 2022."},{"issue":"2","key":"5548_CR10","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1097\/01.AOG.0000168455.39156.0f","volume":"106","author":"I Nygaard","year":"2005","unstructured":"Nygaard I, Girts T, Fultz NH, Kinchen K, Pohl G, Sternfeld B. Is urinary incontinence a barrier to exercise in women? Obstet Gynecol. 2005;106(2):307\u201314. https:\/\/doi.org\/10.1097\/01.AOG.0000168455.39156.0f.","journal-title":"Obstet Gynecol"},{"issue":"24","key":"5548_CR11","doi-asserted-by":"publisher","first-page":"1586","DOI":"10.1136\/bjsports-2017-097587","volume":"52","author":"A Carvalhais","year":"2018","unstructured":"Carvalhais A, Natal Jorge R, B\u00f8 K. Performing high-level sport is strongly associated with urinary incontinence in elite athletes: a comparative study of 372 elite female athletes and 372 controls. Br J Sports Med. 2018;52(24):1586\u201390. https:\/\/doi.org\/10.1136\/bjsports-2017-097587.","journal-title":"Br J Sports Med"},{"issue":"9","key":"5548_CR12","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1111\/sms.12546","volume":"26","author":"MBA Almeida","year":"2016","unstructured":"Almeida MBA, Barra AA, Saltiel F, Silva-Filho AL, Fonseca AMRM, Figueiredo EM. Urinary incontinence and other pelvic floor dysfunctions in female athletes in Brazil: a cross-sectional study. Scand J Med Sci Sports. 2016;26(9):1109\u201316. https:\/\/doi.org\/10.1111\/sms.12546.","journal-title":"Scand J Med Sci Sports"},{"issue":"8","key":"5548_CR13","doi-asserted-by":"publisher","first-page":"1551","DOI":"10.1007\/s00192-020-04531-x","volume":"31","author":"LB Forner","year":"2020","unstructured":"Forner LB, Beckman EM, Smith MD. Symptoms of pelvic organ prolapse in women who lift heavy weights for exercise: a cross-sectional survey. Int Urogynecol J. 2020;31(8):1551\u20138. https:\/\/doi.org\/10.1007\/s00192-020-04531-x.","journal-title":"Int Urogynecol J"},{"issue":"8","key":"5548_CR14","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1007\/s00192-016-2954-3","volume":"27","author":"S McKenzie","year":"2016","unstructured":"McKenzie S, Watson T, Thompson J, Briffa K. Stress urinary incontinence is highly prevalent in recreationally active women attending gyms or exercise classes. Int Urogynecol J. 2016;27(8):1175\u201384. https:\/\/doi.org\/10.1007\/s00192-016-2954-3.","journal-title":"Int Urogynecol J"},{"issue":"7624","key":"5548_CR15","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","volume":"335","author":"E Von Elm","year":"2007","unstructured":"Von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007;335(7624):806\u20138. https:\/\/doi.org\/10.1136\/bmj.39335.541782.AD.","journal-title":"BMJ"},{"issue":"4","key":"5548_CR16","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1017\/s1463423614000371","volume":"16","author":"J Cooper","year":"2015","unstructured":"Cooper J, Annappa M, Quigley A, Dracocardos D, Bondili A, Mallen C. Prevalence of female urinary incontinence and its impact on quality of life in a cluster population in the United Kingdom (UK): a community survey. Primary Health Care Res Dev. 2015;16(4):377\u201382. https:\/\/doi.org\/10.1017\/s1463423614000371.","journal-title":"Primary Health Care Res Dev"},{"key":"5548_CR17","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1002\/nau.20041","volume":"23","author":"K Avery","year":"2004","unstructured":"Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurol Urodyn. 2004;23:322\u201330. https:\/\/doi.org\/10.1002\/nau.20041.","journal-title":"Neurol Urodyn"},{"issue":"10","key":"5548_CR18","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1097\/DCR.0b013e3182272128","volume":"54","author":"N Cotterill","year":"2011","unstructured":"Cotterill N, Norton C, Avery KN, Abrams P, Donovan JL. Psychometric evaluation of a new patient-completed questionnaire for evaluating anal incontinence symptoms and impact on quality of life: the ICIQ-B. Dis Colon Rectum. 2011;54(10):1235\u201350. https:\/\/doi.org\/10.1097\/DCR.0b013e3182272128.","journal-title":"Dis Colon Rectum"},{"issue":"6","key":"5548_CR19","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1111\/j.1471-0528.2006.00938.x","volume":"113","author":"N Price","year":"2006","unstructured":"Price N, Jackson S, Avery K, Brookes S, Abrams P. Development and psychometric evaluation of the ICIQ Vaginal Symptoms Questionnaire: the ICIQ-VS. BJOG. 2006;113(6):700\u201312. https:\/\/doi.org\/10.1111\/j.1471-0528.2006.00938.x.","journal-title":"BJOG"},{"issue":"5","key":"5548_CR20","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1002\/nau.20674","volume":"28","author":"A Klovning","year":"2009","unstructured":"Klovning A, Avery K, Sandvik H, Hunskaar S. Comparison of two questionnaires for assessing the severity of urinary incontinence: The ICIQ-UI SF versus the incontinence severity index. Neurourol Urodyn. 2009;28(5):411\u20135. https:\/\/doi.org\/10.1002\/nau.20674.","journal-title":"Neurourol Urodyn"},{"issue":"4","key":"5548_CR21","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1016\/j.ajog.2006.02.050","volume":"195","author":"MD Barber","year":"2006","unstructured":"Barber MD, Neubauer NL, Klein-Olarte V. Can we screen for pelvic organ prolapse without a physical examination in epidemiologic studies? Am J Obstet Gynecol. 2006;195(4):942\u20138. https:\/\/doi.org\/10.1016\/j.ajog.2006.02.050.","journal-title":"Am J Obstet Gynecol"},{"key":"5548_CR22","unstructured":"Campbell KG, Batt ME, Drummond A. Perspectives of women living and exercising with pelvic floor disorders: findings from the \u2018PREDICT\u2019 survey. J Pelvic Obstet Gynaecol Physiother. (In press)."},{"issue":"6","key":"5548_CR23","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1590\/1517-869220152106140065","volume":"21","author":"MP Araujo","year":"2015","unstructured":"Araujo MP, Parmigiano TR, Della Negra LG, et al. Evaluation of athletes\u2019 pelvic floor: is there a relation with urinary incontinence? Rev Bras Med Esp. 2015;21(6):442\u20136. https:\/\/doi.org\/10.1590\/1517-869220152106140065.","journal-title":"Rev Bras Med Esp"},{"issue":"4","key":"5548_CR24","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1007\/s00192-021-04696-z","volume":"33","author":"KL Skaug","year":"2022","unstructured":"Skaug KL, Engh ME, Frawley H, B\u00f8 K. Urinary and anal incontinence among female gymnasts and cheerleaders\u2014bother and associated factors. A cross-sectional study. Int Urogynecol J. 2022;33(4):955\u201364. https:\/\/doi.org\/10.1007\/s00192-021-04696-z.","journal-title":"Int Urogynecol J"},{"issue":"3","key":"5548_CR25","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1007\/s00404-022-06510-7","volume":"306","author":"MG Gabra","year":"2022","unstructured":"Gabra MG, Tessier KM, Fok CS, Nakib N, Oestreich MC, Fischer J. Pelvic organ prolapse and anal incontinence in women: screening with a validated epidemiology survey. Arch Gynecol Obstet. 2022;306(3):779\u201384. https:\/\/doi.org\/10.1007\/s00404-022-06510-7.","journal-title":"Arch Gynecol Obstet"},{"key":"5548_CR26","doi-asserted-by":"publisher","first-page":"100571","DOI":"10.1016\/j.cont.2022.100571","volume":"5","author":"R Everist","year":"2023","unstructured":"Everist R, Burrell M, Parkin K, Patton V, Karantanis E. The long-term prevalence of anal incontinence in women with and without obstetric anal sphincter injuries. Continence. 2023;5:100571. https:\/\/doi.org\/10.1016\/j.cont.2022.100571.","journal-title":"Continence"},{"issue":"12","key":"5548_CR27","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1055\/s-0043-115736","volume":"38","author":"JO Alves","year":"2017","unstructured":"Alves JO, Luz STD, Brandao S, Da Luz CM, Jorge RN, Da Roza T. Urinary incontinence in physically active young women: prevalence and related factors. Int J Sports Med. 2017;38(12):937\u201341. https:\/\/doi.org\/10.1055\/s-0043-115736.","journal-title":"Int J Sports Med"},{"issue":"5","key":"5548_CR28","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1007\/s00192-019-04074-w","volume":"31","author":"C Carvalho","year":"2020","unstructured":"Carvalho C, da Silva Serr\u00e3o PRM, Beleza ACS, Driusso P. Pelvic floor dysfunctions in female cheerleaders: a cross-sectional study. Int Urogynecol J. 2020;31(5):999\u20131006. https:\/\/doi.org\/10.1007\/s00192-019-04074-w.","journal-title":"Int Urogynecol J"},{"issue":"1","key":"5548_CR29","first-page":"21","volume":"27","author":"C Carls","year":"2007","unstructured":"Carls C. The prevalence of stress urinary incontinence in high school and college-age female athletes in the midwest: implications for education and prevention. Urol Nurs. 2007;27(1):21\u20134, 39.","journal-title":"Urol Nurs"}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-023-05548-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00192-023-05548-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-023-05548-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,21]],"date-time":"2023-10-21T10:02:58Z","timestamp":1697882578000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00192-023-05548-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,10]]},"references-count":29,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["5548"],"URL":"https:\/\/doi.org\/10.1007\/s00192-023-05548-8","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,10]]},"assertion":[{"value":"10 February 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 April 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 May 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the University of Nottingham, Faculty of Medicine and Health Sciences Research Ethics Committee FMHS 501\u20130322. All participants gave electronic consent before progressing to data collection. Data were anonymised at source and no individual IP addresses were retained.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"None.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"A summary of the data set generated and analysed during the current study may be available from the corresponding author on reasonable request.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data sharing"}},{"value":"A patient representative, who has experienced pelvic floor dysfunction and its impact on her sport, was involved as a member of the study steering group from its inception and took an equal part in all aspects of design of the survey, study protocol and decisions regarding advertising and analysis. She will continue to be involved as a member of the steering group to decide on potential ways to disseminate the results to the public going forward. Further, local women were recruited to pilot initial versions of the survey to identify any issues with wording and content. The final version was modified based on their feedback.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Public and patient involvement"}}]}}