Analysis of Predictive Factors for Return to Sports in Female Athletes With Stress Urinary Incontinence

Abstract

Introduction This study aimed to identify predictive factors for successful return to sports among elite female athletes (EFAs) experiencing stress urinary incontinence (SUI). We used machine learning to analyze these predictors. Methods This study was conducted at Yokosuka Urogynecology and Urology Clinic, located in Yokosuka City, Kanagawa, Japan. A total of 153 EFAs with postpartum SUI were included in this retrospective cohort study. Information regarding the frequency of pelvic floor muscle training (PFMT), treatment approaches, rates of return to sports after one year, and one-hour pad test (1HrPadtest) at three months were collected. Results At three months, 26.8% of the EFAs improved in SUI; after one year, 28.1% returned to their respective sports successfully. The equation for predicting return to sports (logit(p)) involved several factors: (a) serum total testosterone, (b) PFMT frequency per week, (c) 1HrPadtest at three months, and (d) vaginal erbium-doped yttrium aluminum garnet laser (VEL) + urethral EL (UEL) treatment. The equation was as follows: -126 - 0.07276a + 25.98b - 1.947c - 25.32d, with a logit(p) cutoff point at 0.5. The optimal cutoff values and the four influential factors were determined through a receiver operating characteristic (ROC) analysis and the random forest model, respectively. Conclusions For EFAs with severe SUI to successfully return to their sports activities, the PFMT frequency was paramount. Patients who exhibited unsatisfactory results in the 1HrPadtest at the three-month mark benefited from the VEL+UEL treatment. Serum total testosterone proved to be an effective discerning criterion.

Mesh Extraction Surgery and Laser Treatment for Pain After Mid-Urethral Sling Surgery: A Case Series

“…Both VEL and UEL were well tolerated in our study, with no reported complaints from the patients, such as burning during urination or dysuria. Furthermore, there were no observed indications of a risk of urethral stricture associated with laser therapy, which is consistent with previous research [8][9][10][11][12][13][14]19,20].…”

“…Our selection consisted of the non-ablative erbium:yttrium-aluminum-garnet (Er:YAG) SMOOTH® laser, accompanied by a laser tailored for the vagina (vaginal erbium laser (VEL)) and the urethra (urethra erbium laser (UEL)). Previous reports showed that a combination of VEL and UEL improved severe SUI [8][9][10][11][12][13][14]. VEL itself is very 1 2 safe, with few side effects observed [12,14].…”

“…VEL itself is very 1 2 safe, with few side effects observed [12,14]. An illustrative case of severe SUI underwent combined VEL and UEL treatment, demonstrating MRI-documented changes and the uniformization of urethral circumference [8]. The effects of VEL and UEL, using the SMOOTH modalities, involve the use of a 2940 nm SMOOTH Er:YAG laser with high water affinity.…”

“…VEL and UEL employ a series of non-ablative micropulses to deliver heat penetration at depths of approximately 400-500 um, stimulating tissue regeneration, collagen formation, and blood vessel development. This process occurs without surface damage and has been observed to affect tissues up to 2 mm deep in the mucosa [8][9][10][11][12][13][14].…”

Innovative decision making tools using discrete mathematics for stress urinary incontinence treatment

“…This study aimed to develop a graph theory-based navigation system using data from previous research, focusing on the treatment choices for Stress Urinary Incontinence (SUI). SUI affects a significant proportion of women, significantly diminishing their quality of life 7 – 10 . A common treatment is mid-urethral sling (MUS) procedures using polypropylene mesh, but this method can lead to postoperative pain, foreign body reactions, inflammation, and even the emergence or worsening of Urgency Urinary Incontinence (UUI) 11 – 13 .…”