Urinary incontinence and other pelvic floor dysfunctions in female athletes in Brazil: A cross‐sectional study

Abstract

The pelvic floor (PF) provides support to all pelvic organs, as well as appropriately closure/opening mechanism of the urethra, vagina, and anus. Therefore, it is likely that female athletes involved in high-impact and in strong-effort activities are at risk for the occurrence of urinary incontinence (UI). This study aimed to investigate the occurrence of UI and other PF dysfunctions (PFD) [anal incontinence (AI), symptoms of constipation, dyspareunia, vaginal laxity, and pelvic organ prolapse] in 67 amateur athletes (AT) compared with a group 96 of nonathletes (NAT). An ad hoc survey based on questions from reliable and valid instruments was developed to investigate the occurrence of PFD symptoms. The risk of UI was higher in AT group (odds ratio: 2.90; 95% CI: 1.50-5.61), mostly among artistic gymnastics and trampoline, followed by swimming and judo athletes. Whereas, AT group reported less straining to evacuate (OR: 0.46; 95% CI: 0.22-0.96), manual assistance to defecate (OR: 0.24; 95% CI: 0.05-1.12), and a higher stool frequency (OR: 0.29; 95% CI: 0.13-0.64) than NAT group. The occurrence of loss of gas and sexual symptoms was high for both groups when compared with literature, although with no statistical difference between them. Pelvic organ prolapse was only reported by nonathletes. Athletes are at higher risk to develop UI, loss of gas, and sexual dysfunctions, either practicing high-impact or strong-effort activities. Thus, pelvic floor must be considered as an entity and addressed as well. Also, women involved in long-term high-impact and strengthening sports should be advised of the impact of such activities on pelvic floor function and offered preventive PFD strategies as well.

Performing high-level sport is strongly associated with urinary incontinence in elite athletes: a comparative study of 372 elite female athletes and 372 controls

“…Other studies have a wide prevalence range in swimmers, varying from 6%16 to 84.6% 17. Although in aquatic sports the body is partially immersed in water and therefore ground reaction forces have no impact on the pelvic floor, some differences could exist between modalities in terms of abrupt and repetitive increases in IAP due to twisting and other specific sport body movements.…”

“…A systematic review by Bø15 showed that the highest prevalence of UI during sports involved high-impact activities, such as gymnastics and ball games. Regarding the prevalence of UI in different sports, the rates vary between 0% in golf players16 and 88.9% in artistic gymnastics and trampoline athletes 17…”

Role of chronic exercise on pelvic floor support and function

“…18 In another report, athletes exhibited greater odds for urinary incontinence compared to non-athletes (OR=2.90; 95% CI: 1.50–5.61), with ~27% of controls reporting mostly urgency urinary incontinence and ~52% of athletes reporting mostly stress urinary incontinence. 19 Interestingly, self-reported bowel function was better among athletes compared to controls and only controls reported any symptoms of pelvic organ prolapse, yet the authors warn of potential PF damage for women engaged in sporting activity.…”

A prática esportiva e o assoalho pélvico feminino: uma revisão da literatura.

“…Recentemente tem sido descrito nos estudos a IU em mulheres relacionada ao esporte 10,11,23,24 .A prevalência de IU em atletas está associada com o tipo de esporte, sendo que o acometimento é mais comum em praticantes de esportes de alto impacto 6,1 . É importante ressaltar que trata-se de uma situação que afeta o componente psicológico da atleta, podendo levar ao abandono do esporte e consequente inatividade, tanto da atleta competitiva como da atleta recreacional 14,21,25 .…”