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

  • Renata Veloso Teixeira
  • Cássia Colla
  • Graciele Sbruzzi
  • Anelise Mallmann
  • Luciana Laureano Paiva
Review Article
  • 51 Downloads

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.

Keywords

Athlete Urinary incontinence Women 

Notes

Compliance with ethical standards

Conflicts of interest

None.

References

  1. 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. 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.CrossRefPubMedGoogle Scholar
  3. 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. 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.CrossRefGoogle Scholar
  5. 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.CrossRefPubMedGoogle Scholar
  6. 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.CrossRefPubMedGoogle Scholar
  7. 7.
    Caetano AS, Tavares MCGFT, Lopes MHBM. Incontinência urinária e a prática de atividades físicas. Rev Bras Med Esporte. 2007;13(4):270–4.CrossRefGoogle Scholar
  8. 8.
    Higa R, Lopes MHBM, Reis MJ. Fatores de risco para incontinência urinária na mulher. Rev Esc Enferm USP. 2008;42(1):187–92.CrossRefPubMedGoogle Scholar
  9. 9.
    Bo K. Urinary incontinence, pelvic floor dysfunction, exercise and sport. Sports Med. 2004;34(7):451–64.CrossRefPubMedGoogle Scholar
  10. 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.CrossRefGoogle Scholar
  11. 11.
    Nygaard IE, Thompson FL, Svengalis SL, Albright JP. Urinary incontinence in elite nulliparous athletes. Obstet Gynecol. 1994;84(2):183–5.PubMedGoogle Scholar
  12. 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.CrossRefGoogle Scholar
  13. 13.
    The Cochrane Collaboration. Cochrane Library. Disponível em <www.thecochranelibrary.com/view/0/index.html>. Acesso em 10 ago 2016.
  14. 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.CrossRefPubMedGoogle Scholar
  15. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 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.CrossRefGoogle Scholar
  17. 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.PubMedGoogle Scholar
  18. 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. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 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. 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. 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.CrossRefGoogle Scholar
  23. 23.
    Borin LCMS, Nunes FR, Guirro ECOG. Assessment of pelvic floor muscle pressure in female athletes. PM&R. 2013;5(1):189–93.CrossRefGoogle Scholar
  24. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 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.CrossRefGoogle Scholar
  26. 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.CrossRefGoogle Scholar
  27. 27.
    Almeida PP, Machado LRG. A prevalência de incontinência urinária em mulheres praticantes de jump. Fisioter Mov. 2012;25(1):55–65.CrossRefGoogle Scholar
  28. 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.CrossRefGoogle Scholar
  29. 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. 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.CrossRefPubMedGoogle Scholar
  31. 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.CrossRefPubMedGoogle Scholar
  32. 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.CrossRefPubMedGoogle Scholar
  33. 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.CrossRefGoogle Scholar
  34. 34.
    Nygaard I, Delancey JO, Arnsdorf L, Murphy E. Exercise and incontinence. Obstet Gynecol. 1990;75(5):848–51.PubMedGoogle Scholar
  35. 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;Google Scholar
  36. 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.CrossRefGoogle Scholar
  37. 37.
    Janet SM, Nygaard IE. Role of chronic exercise on pelvic floor support and function. Curr Opin Urol. 2017;27(3):257–61.CrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2018

Authors and Affiliations

  1. 1.School of Physical Education, Physical Therapy and DanceUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
  2. 2.Postgraduate Program in Health Sciences: Gynecology and ObstetricsUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
  3. 3.Specialization in Kinesiology by the School of Physical Education and DanceUniversidade Federal do Rio Grande do SulPorto AlegreBrazil

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