Pelvic floor complaints in gastroenterology practice: results of a survey in the netherlands

Abstract

ObjectiveThe pelvic floor is an integrated structure; dysfunctions may lead to a wide range of symptoms, involving voiding, defecation and sexual functioning (SF). Functional symptoms such as constipation and lower abdominal pain are often caused by pelvic floor dysfunction (PFD), and they highly impact the quality of life. Multiple specialists are responsible for a specific part of the pelvic floor, but its treatment asks for a holistic approach. The authors are still unaware of gastroenterologists' knowledge on PFD or whether they are addressing pelvic floor complaints in their daily practice.DesignA 42-itemed anonymous questionnaire was mailed to all 402 members of the Dutch Society of Gastroenterology (gastroenterologists and residents-in-training).Results169 (42%) questionnaires were analysed. Most gastroenterologists address lower urinary tract symptoms in their history-taking, 92% in female patients and 84% in male patients. When patients indicate irritable bowel syndrome-like complaints, more than 60% of the physicians inquire about SF to their female patients, compared with 38% inquiries to male patients (p<0.001). A reason not to inquire about SF is a lack of knowledge about female and male sexuality (19% and 23%, respectively). Forty-six per cent of the respondents regard it rather important to receive more training on PFD in male patients versus 61% in female patients.ConclusionAwareness of PFD is not yet routinely integrated into the history taken by gastroenterologists.

Prevalence and triage of first contact pelvic floor dysfunction complaints in male patients referred to a Pelvic Care Centre

“…Our findings are in line with the conclusions of the European Association of Urology guidelines‐ that voiding dysfunction often occurs in association with other PFDs, such as FI and sexual problems . Faecal problems have also been associated with a negative impact on sexual function …”

“…In a survey Nicolai et al assessed whether or not gastroenterologists addressed male's sexual function during consultation for intestine, colon, or anorectal problems. They revealed that only 2.5% did so.…”

Comorbidities in functional gastrointestinal diseases: Do we need a lone ranger or a dream team?

“…These patients are very likely to have a dysfunction of the pelvic floor and might need to be referred to a pelvic floor physiotherapist, sexologist, urologist or a psychologist to treat the globality of their complaints. This is probably due to a lack of experience in this field or a lack of time in their daily practice [11].…”