Frontline Gastroenterol doi:10.1136/flgastro-2012-100133
  • Training Matters
  • Research

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

  1. Henk W Elzevier1
  1. 1Department of Urology, Leiden University Medical Center, Leiden, The Netherlands
  2. 2Department of Gastroenterology, Utrecht University Medical Center, Utrecht, The Netherlands
  3. 3Department of Surgery, Haaglanden Medical Center, the Hague, The Netherlands
  4. 4Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to Dr H W Elzevier, Department of Urology, LUMC, Albinusdreef 2, Leiden, The Netherlands; H.W.Elzevier{at}
  1. Contributors MPJN designed the questionnaire, was responsible for data collection for the whole survey, cleaned and analysed the data, drafted and revised the paper, and is the guarantor. HHF designed the questionnaire, contributed to the data collection, monitored data collection for the whole trial, and revised the draft paper. MDB revised the draft paper. HP wrote the statistical analysis plan and supervised data analysis. RCMP revised the draft paper. HWE designed the protocol, designed the questionnaire, monitored data collection for the whole survey, revised and approved the paper, and is the supervisor of the study.

  • Received 27 January 2012
  • Accepted 28 February 2012
  • Published Online First 24 April 2012


Objective The 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.

Design A 42-itemed anonymous questionnaire was mailed to all 402 members of the Dutch Society of Gastroenterology (gastroenterologists and residents-in-training).

Results 169 (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.

Conclusion Awareness of PFD is not yet routinely integrated into the history taken by gastroenterologists.


  • Competing interests None

  • Provenance and peer review Not commissioned; externally peer reviewed

  • Data sharing statement The authors state that additional unpublished data from the study will be shared with Frontline Gastroenterology if necessary.

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