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Prevalence of urinary incontinence in female athletes: a systematic review with meta-analysis

International Urogynecology Journal volume 29, pages 1717–1725 (2018)Cite this article

Abstract

Urinary incontinence (UI) is any involuntary loss of urine. In female athletes, physical exercise may be a risk factor for UI because of increased intra-abdominal pressure generated during high-impact exercises, which overloads the pelvic organs, predisposing them to UI. This is a systematic review of the prevalence of UI in female athletes in different sports. A search for articles was carried out in the PEDro, Scopus, Cinahl, PubMed, LILACS, SciELO, Science Direct, Web of Science, Embase, and Cochrane databases as well as a manual search of the references of studies already published on the subject with the keywords “athlete,” “urinary incontinence,” and “women” in Portuguese and English. Only articles published from 2000 to 2016 were included. Observational studies assessing the prevalence of UI in female athletes were selected. Methodological quality was assessed using the Downs and Black scale, and the data collected from the studies were analyzed through meta-analysis. Eight studies met the eligibility criteria. Meta-analysis showed a 36% prevalence of UI in female athletes in different sports, and compared with sedentary women, the athletes had a 177% higher risk of presenting with UI. There is a higher prevalence of UI in female athletes compared with sedentary women. There have been reports of UI in different sports.

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References

  1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the international continence society. Neurourol Urodyn. 2003;21(1):167–78.

    Google Scholar 

  2. Santos ES, Caetano AS, Tavares MCGCF, Lopes MHBM. Incontinência urinária entre estudantes de educação física. Rev Esc Enferm USP. 2009;43(2):307–12.

    Article  PubMed  Google Scholar 

  3. Jácome C, Oliveira D, Marques A, Sá-Couto P. Prevalence and impact of urinary incontinence among female athletes. IJGO. 2011;114(1):60–3.

    Google Scholar 

  4. Dedicação AC, Haddad M, Saldanha MES, Driusso P. Comparação da qualidade de vida nos diferentes tipos de incontinência urinária feminina. Rev Bras Fisioter. 2009;13(2):116–22.

    Article  Google Scholar 

  5. Nygaard IE, Glowacki C, Saltzman CL. Relationship between foot flexibility and urinary incontinence in nulliparous varsity athletes. Obstet Gynecol. 1996;87(6):1049–51.

    CAS  Article  PubMed  Google Scholar 

  6. Nygaard IE. Does prolonged high-impact activity contribute to later urinary incontinence? A retrospective cohort study of female olympians. Obstet Gynecol. 1997;90(5):718–22.

    CAS  Article  PubMed  Google Scholar 

  7. Caetano AS, Tavares MCGFT, Lopes MHBM. Incontinência urinária e a prática de atividades físicas. Rev Bras Med Esporte. 2007;13(4):270–4.

    Article  Google Scholar 

  8. Higa R, Lopes MHBM, Reis MJ. Fatores de risco para incontinência urinária na mulher. Rev Esc Enferm USP. 2008;42(1):187–92.

    Article  PubMed  Google Scholar 

  9. Bo K. Urinary incontinence, pelvic floor dysfunction, exercise and sport. Sports Med. 2004;34(7):451–64.

    Article  PubMed  Google Scholar 

  10. Reis AO, Câmara CNS, Santos SG, Dias TS. Estudo comparativo da capacidade de contração do assoalho pélvico em atletas de voleibol e basquetebol. Rev Bras Med Esporte. 2011;17(2):97–101.

    Article  Google Scholar 

  11. Nygaard IE, Thompson FL, Svengalis SL, Albright JP. Urinary incontinence in elite nulliparous athletes. Obstet Gynecol. 1994;84(2):183–5.

    CAS  PubMed  Google Scholar 

  12. Almousa S, Moser H, Kitsoulis G, Almousa N, Tzovaras H, Kastani D. The prevalence of urine incontinence in nulliparous female athletes: a systematic review. Physiotherapy. 2015;101(1):58.

    Article  Google Scholar 

  13. The Cochrane Collaboration. Cochrane Library. Disponível em <www.thecochranelibrary.com/view/0/index.html>. Acesso em 10 ago 2016.

  14. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the prisma statement. Ann Intern Med. 2009;151(4):264–9.

    Article  PubMed  Google Scholar 

  15. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52(1):377–84.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  16. Araújo MP, Parmigiano TR, Negra LGD, Toreli L, Carvalho CG, Wo L, et al. Avaliação do assoalho pélvico de atletas: existe relação com a incontinência urinária? Rev Bras Med Esporte. 2015;21(6):442–6.

    Article  Google Scholar 

  17. Simeone C, Moroni A, Pettenò A, Antonelli A, Zani D, Orizio C, et al. Occurrence rates and predictors of lower urinary tract symptoms and incontinence in female athletes. Urologia. 2010;77(2):139–46.

    CAS  Article  PubMed  Google Scholar 

  18. Patrizzi LJ, Viana DA, Silva LMA, Pegorari MS. Incontinência urinária em mulheres jovens praticantes de exercício físico. Rev Bras Ciênc Mov. 2014;22(3):105–10.

    Google Scholar 

  19. Dieter AA, Wilkins MF, Wu JM. Epidemiological trends and future care needs for pelvic floor disorders. Curr Opin Obstet Gynecol. 2015;27(5):380–4.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Silva LH, Serezuella KC, Bordini A, Citadini JM. Relação da incontinência urinária de esforço com a prática de atividades físicas em mulheres nulíparas. Salusvita. 2005;24(2):195–206.

    Google Scholar 

  21. Neyeloff JL, Fuchs SC, Moreira LB. Meta-analyses and Forest plots using a microsoft excel spreadsheet: step-by-step guide focusing on descriptive data analysis. BMC Res Notes. 2012;52(5):1–6.

    Google Scholar 

  22. Fozzati C, Riccetto C, Herrmann V, Brancalion MF, Raimondi M, Nascif CH, et al. Prevalence study of stress urinary incontinence in women who perform high-impact exercises. Int Urogynecol J. 2012;23(1):1687–91.

    Article  Google Scholar 

  23. Borin LCMS, Nunes FR, Guirro ECOG. Assessment of pelvic floor muscle pressure in female athletes. PM&R. 2013;5(1):189–93.

    Article  Google Scholar 

  24. Póswiata A, Socha T, Opara J. Prevalence of stress urinary incontinence in elite female endurance athletes. J Hum Kinet. 2014;44(1):91–6.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Larsen IW, Yavorek TA. Pelvic organ prolapse and urinary incontinence in nulliparous women the United States Military Academy. Int Urogynecol J. 2006;17(1):208–10.

    Article  Google Scholar 

  26. Thyssen HH, Clevin L, Olesen S, Lose G. Urinary incontinence in elite female athletes and dancers. Int Urogynecol J. 2002;13(1):15–7.

    CAS  Article  Google Scholar 

  27. Almeida PP, Machado LRG. A prevalência de incontinência urinária em mulheres praticantes de jump. Fisioter Mov. 2012;25(1):55–65.

    Article  Google Scholar 

  28. Mohedo ED, Morales NM, Porqueres IM, Galán CP, López FJB. Análisis de la incontinencia urinaria en la mujer deportista. Fisioterapia. 2004;26(6):314–8.

    Article  Google Scholar 

  29. Bo K, Borgen JS. Prevalence of stress and urge urinary incontinence in elite athletes and controls. Med Sci Sports Exerc. 2011;33(11):1797–802.

    Google Scholar 

  30. Eliasson K, Larsson T, Mattsson E. Prevalence of stress incontinence in nulliparous elite trampolinists. Scand J Med Sci Sports. 2002;12(1):106–10.

    CAS  Article  PubMed  Google Scholar 

  31. Davis G, Sherman R, Wong MF, McClure G, Perez R, Hibbert M. Urinary incontinence among female soldiers. Mil Med. 1999;164(3):182–7.

    CAS  Article  PubMed  Google Scholar 

  32. Araújo MP, Oliveira E, Zucchi EVM, Trevisani VFM, Girão MJBC, Sartori MGF. Relação entre incontinência urinária em mulheres atletas corredoras de longa distância e distúrbio alimentar. Rev Assoc Med Bras. 2008;54(2):146–9.

    Article  PubMed  Google Scholar 

  33. Yeung SS, Au AL, Chow CC. Effects of fatigue on the temporal neuromuscular control of vastus medial muscle in humans. Eur J Appl Occup Physiol. 1999;80(4):379–85.

    CAS  Article  Google Scholar 

  34. Nygaard I, Delancey JO, Arnsdorf L, Murphy E. Exercise and incontinence. Obstet Gynecol. 1990;75(5):848–51.

    CAS  PubMed  Google Scholar 

  35. Carvalhais A, Natal Jorge R, Bo 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. 2017;

  36. Middlekauff ML, Egger MJ, Nygaard IE, Shaw JM. The impact of acute and chronic strenuous exercise on pelvic floor muscle strength and support in nulliparous healthy women. Am J Obstet Gynecol. 2016;215(3):316: 1-7.

    Article  Google Scholar 

  37. Janet SM, Nygaard IE. Role of chronic exercise on pelvic floor support and function. Curr Opin Urol. 2017;27(3):257–61.

    Article  Google Scholar 

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Authors and Affiliations

  1. School of Physical Education, Physical Therapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    Renata Veloso Teixeira, Graciele Sbruzzi & Luciana Laureano Paiva

  2. Postgraduate Program in Health Sciences: Gynecology and Obstetrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    Cássia Colla

  3. Specialization in Kinesiology by the School of Physical Education and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    Anelise Mallmann

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  1. Renata Veloso Teixeira
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  2. Cássia Colla
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Correspondence to Cássia Colla.

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Teixeira, R.V., Colla, C., Sbruzzi, G. et al. Prevalence of urinary incontinence in female athletes: a systematic review with meta-analysis. Int Urogynecol J 29, 1717–1725 (2018). https://doi.org/10.1007/s00192-018-3651-1

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  • DOI: https://doi.org/10.1007/s00192-018-3651-1

Keywords

  • Athlete
  • Urinary incontinence
  • Women