Prevention and management of urinary incontinence, anal incontinence and pelvic organ prolapse in military women and female elite athletes

Background: Pelvic floor dysfunction (PFD), encompassing urinary incontinence (UI), anal incontinence (AI), pelvic organ prolapse (POP) and various other conditions associated with pelvic floor muscles, is prevalent in military women and female elite athletes. Thus, it is important to consider specific prevention and management strategies that these women are currently using, and their safety and effectiveness. Purpose: To determine specific prevention and management interventions for UI, AI and POP used by female military personnel and elite athletes, and their safety and effectiveness. Materials and methods: Eight databases were searched for studies on prevention and management of UI, AI and POP using keywords such as 'female', 'military', 'athlete' and 'pelvic floor dysfunction'. Studies were selected and appraised by two independent reviewers. Data were extracted, and a critical narrative synthesis approach was implemented. Results: The systematic search identified 581 studies; eight were eligible for inclusion in the review. Seven studies focused on UI and one on AI. Pelvic floor muscle training (PFMT) was common and effective in studies of military women and female athletes experiencing UI symptoms. Education was beneficial in female athletes. Concerningly, fluid restriction and pad use were key self-management strategies. Conclusion: PFMT was the most widely used intervention for prevention and management of UI in female military and athlete populations and was found to be safe and effective.