URINARY INCONTINENCE IN FEMALEATHLETES: SYSTEMATIC REVIEW
T. R. LOURENCO1, P.K. MATSUOKA 1, E. C. BARACAT 2, J. M. HADDAD 3;
1Univ. of Sao Paulo, Sao Paulo, Brazil, 2Faculdadede Med. da Univ.e de Sã, São Paulo, Brazil, 3Univ.e deSao Paulo, Sao Paulo, Brazil.
Introduction: Each year peopleare more aware about a healthy lifestyle. However, extenuatingpractice can show no benefits for the pelvic floor. (1) Urinaryincontinence is a prevalent condition in women of all ages thatperform exercises in general, professionally or not. (2) The mostcommon symptom is stress urinary incontinence, that is reported in alarge variety of sports and may interfere in everyday life ortraining, leading the athletes to change or compromise theirperformance. (3)
Objective: To assess theprevalence of urinary incontinence in female athletes and todetermine whether the type of sports, demographic and clinicalcharacteristics might also influence it.
Methods: Asystematic review of the literature was performed, searching PubMed,Cochrane Library, Lilacs until January 23th, 2017. Weelaborate a search strategy, formulated from key words and synonymsfor Pelvic Floor Disorders, Urinary Incontinence, Athletes andSports. The selection criteria were cohorts, ecological studies,case-series that studied women who performed any kind of sports andpresented urinary incontinence prevalence. The subjects are womenathletes, regardless of age, sport’s modality or frequency oftraining. The primary outcome was urinary incontinence prevalence.Two reviewers performed data collection and analysis, independently.All selected studies were methodologically analyzed.
Results:The search strategy identified 385 studies, 24 of which met themethodological criteria for complete analysis. In this review, 8456women were included, between 12 and 79 years old. Only 7 studiescompared physically active women, which included frequently physicalactivities or elite athletes, to inactive women, sedentary or withminimal activity. All the selected studies included high impactactivities that involved jumping, fast running and rotationmovements. In total, nineteen modalities of physical activities wereanalyzed, from marathon and sports with balls to low impact sportslike golf. All women were given a urinary incontinence symptomquestionnaire. ICIQ-SF was the most frequent one. The prevalence ofurinary incontinence varied from 14,9% in women with frequentactivities but not professionals to 80% in trampolinists. When onlyprofessional athletes were questioned, the study with the lowestprevalence of incontinence was 28%, showing that the volume oftraining or frequency of the activities influence urinaryincontinence symptoms. One study analyzed yoga and Pilatesinstructors and found an incontinence prevalence of 26,4%. Anotherstudy included women who practice golf, showing 0% of incontinencesymptoms. None of them included pregnant women or those who haddelivered in less than 1 year. Factors like hormonal contraception,hormonal replacement therapies, smoking or use of medications couldnot be well evaluated as they are not mentioned or described indetails in most of the studies. Unfortunately, the objectiveevaluation is not habitually performed as it has technicaldifficulties and little reproducibility, as Pad Test, with someinterference factors like sweating.
Conclusions: Analysisof these data suggests that urinary incontinence prevalence variesconsiderably and it is influenced by the modality of sport performedby women.
References: 1) Contemporary Clinical Trials 33(2012) 819-827 2) Br J Sports Med 2014;48:296-298 3) Br J Sports Med.2009;43(14):1115-8 <!--EndFragment-->