Coronavirus Disease 2019 (COVID-19) and pelvic floor signs and symptoms: a scoping review of the literature

Valentina Di Tommaso; Marta Rossi; Silvia Gianola; Greta Castellini; Silvia Bargeri; Giacomo Rossettini; Arianna Bortolami

doi:10.33393/aop.2025.3188

Authors

Valentina Di Tommaso Studio di fisioterapia PelviCare, Teramo - Italy https://orcid.org/0009-0004-0487-5004
Marta Rossi Ospedale Papa Giovanni XXIII, Bergamo - Italy https://orcid.org/0009-0003-9873-0596
Silvia Gianola Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan - Italy https://orcid.org/0000-0003-3770-0011
Greta Castellini Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan - Italy https://orcid.org/0000-0002-3345-8187
Silvia Bargeri Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan - Italy https://orcid.org/0000-0002-3489-6429
Giacomo Rossettini Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid - Spain https://orcid.org/0000-0002-1623-7681
Arianna Bortolami Pelvic Floor Studio, Padua - Italy https://orcid.org/0000-0002-4850-123X

DOI:

https://doi.org/10.33393/aop.2025.3188

Keywords:

Anorectal bowel symptoms, COVID-19, Lower urinary tract symptoms, Pelvic floor, Sexual dysfunction

Abstract

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic presents a substantial global health challenge. While the disease is known to impact multiple systems, leading to long-term consequences that require monitoring and rehabilitation, its effects on the pelvic floor remain unclear.
Methods:We conducted a scoping review following the Arksey and O’Malley framework. A systematic search was performed in PubMed, CINAHL, and Embase databases up to March 19, 2024, to identify studies examining pelvic floor-related signs and symptoms in COVID-19 patients. Two reviewers independently extracted study and participant characteristics, areas involved (e.g., anorectal, sexual, urogenital), and signs and symptoms using an ad-hoc data extraction form. Signs and symptoms were classified as direct (e.g., directly impacting the pelvic floor) or indirect (e.g., indirectly affecting it with potential long-term consequences).
Results: We included 104 studies, primarily a systematic review (N = 40; 38.46%) and focused on adult populations (N = 80; 76.92%), investigating 140 signs and symptoms from various regions worldwide. Most (N = 124; 88.57%) were indirect signs and symptoms, while the minority were direct (N = 16; 11.43%). The most prevalent indirect symptom was diarrhea (n = 81; 70,43%) in the anorectal bowel area (n = 115). The most prevalent direct were lower urinary tract symptoms (LUTS) (n = 16; 84.21%) in the urogenital area (n = 19).
Conclusion: This study highlights the significant prevalence of both direct and indirect pelvic floor symptoms in COVID-19 patients. Clinicians should be aware of the potential link between COVID-19 and pelvic floor dysfunction.

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References

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