Journal Article•
Does prolonged high-impact activity contribute to later urinary incontinence? A retrospective cohort study of female olympians
TL;DR: For example, this paper found that participants who participated in Olympic sport were more likely to report stress and urge incontinence, compared with those who did not participate in Olympic sports.
Abstract: Objective To determine whether women engaged in strenuous, provocative exercise are more likely to be incontinent in future life than similarly fit women who participated in less provocative exercise. Methods In this retrospective cohort study, female American Olympians who competed in swimming (low-impact group) and in gymnastics and track and field (high-impact group) between 1960 and 1976 completed a structured questionnaire. Primary outcome measures included the prevalence of the symptoms of stress and urge incontinence. Statistical analyses of results included χ 2 , Fisher exact test, two-tailed t tests, Wilcoxon rank sum test, and stepwise multiple logistic regression. P Results One hundred four women responded (response rate 51.2%). High-impact athletes were older (46.2 compared with 42.4 years) and were more likely to report incontinence when they were doing their sport as Olympians (35.8% compared with 4.5%) than low-impact athletes; low-impact athletes were more likely to be parous (83.3% compared with 60.7%). There was no difference in the prevalence of the symptom of stress incontinence between the highversus low-impact groups: any incontinence, 41.1% compared with 50%; daily or weekly incontinence, 10.7% compared with 8.3%; and incontinence that bothered them moderately or greatly, 10.7% compared with 4.2%. With our sample size, this study had 80% power to detect a fourfold difference in daily or weekly incontinence between groups, but only a 30% power to detect a twofold difference, given a baseline prevalence of 10%. When age, body mass index (BMI), parity, Olympic sport group, and incontinence during Olympic sport were entered into stepwise logistic regression analyses, only BMI was significantly associated with regular stress or urge incontinence symptoms. Conclusion Participation in regular, strenuous, highimpact activity when younger did not predispose women to a markedly higher rate of clinically significant urinary incontinence in later life.
Citations
More filters
TL;DR: The previous European Association of Urology (EAU) guidelines on urinary incontinence comprised a summary of sections of the 2009 International Consultation on Incontinence as mentioned in this paper, and a decision was made in 2010 to rewrite these guidelines based on an independent systematic review carried out by the EAU guidelines panel.
351 citations
01 Jan 2017
TL;DR: was included in the ICI 5 edition PFMT (24) vs PFMT + resistance device (28) 52 Women with SUI or MUI (stress predominant) PFMT: 5 quick and 5 slow (sustained), high-intensity contractions daily.
Abstract: was included in the ICI 5 edition PFMT (24) vs PFMT + resistance device (28) 52 Women with SUI or MUI (stress predominant) PFMT: As below without device PFMT +resistance; 5 quick and 5 slow (sustained), high-intensity contractions daily. Advised to hold contractions as long as possible, relaxing their PFM for an equivalent time before repeating the process. Intravaginal resistance: instructions to use the Pelvic-Toner Device concurrently whilst exercising. Two clinic visits and one phone call Reported cure (based on the Q11 of the ICIQFluts) PFMT 0/13 PFMT+resistance 1/15 Non-sign. difference btw groups (p=0.429) Improvement (post-Tx) PFMT 10/19 PFMT+resistance 11/21 Non-sign. difference btw groups 16 weeks of treatment, outcomes assessed at post-Tx and at 6 month follow-up Dropouts (at 6 month) PFMT 9/24 PFMT + resistance 15/28
338 citations
TL;DR: A systematic review of the literature on urinary incontinence and participation in sport and fitness activities with a special emphasis on prevalence and treatment in female elite athletes finds there is a need for more basic research on pelvic floor muscle function during physical activity and the effect of pelvic floor Muscle training inFemale elite athletes.
Abstract: Urinary incontinence is defined as “the complaint of any involuntary leakage of urine” and is a common problem in the female population with prevalence rates varying between 10% and 55% in 15- to 64-year-old women. The most frequent form of urinary incontinence in women is stress urinary incontinence, defined as “involuntary leakage on effort or exertion, or on sneezing or coughing”. The aim of this article is to systematically review the literature on urinary incontinence and participation in sport and fitness activities with a special emphasis on prevalence and treatment in female elite athletes. Stress urinary incontinence is a barrier to women’s participation in sport and fitness activities and, therefore, it may be a threat to women’s health, self-esteem and well-being. The prevalence during sports among young, nulliparous elite athletes varies between 0% (golf) and 80% (trampolinists). The highest prevalence is found in sports involving high impact activities such as gymnastics, track and field, and some ball games. A ‘stiff’ and strong pelvic floor positioned at an optimal level inside the pelvis may be a crucial factor in counteracting the increases in abdominal pressure occurring during high-impact activities. There are no randomised controlled trials or reports on the effect of any treatment for stress urinary incontinence in female elite athletes. However, strength training of the pelvic floor muscles has been shown to be effective in treating stress urinary incontinence in parous females in the general population. In randomised controlled trials, reported cure rates, defined as <2g of leakage on pad tests, varied between 44% and 69%. Pelvic floor muscle training has no serious adverse effects and has been recommended as first-line treatment in the general population. Use of preventive devices such as vaginal tampons or pessaries can prevent leakage during high impact physical activity. The pelvic floor muscles need to be much stronger in elite athletes than in other women. There is a need for more basic research on pelvic floor muscle function during physical activity and the effect of pelvic floor muscle training in female elite athletes.
319 citations
TL;DR: To review the epidemiological literature of urinary incontinence with respect to overweight and obesity as a risk factor, and how the findings eventually fulfill general criteria for being a causal factor for the condition.
Abstract: Aims
To review the epidemiological literature of urinary incontinence with respect to overweight and obesity as a risk factor, and how the findings eventually fulfill general criteria for being a causal factor for the condition. Likewise to review all interventional studies assessing the effect of weight reduction on incontinence.
Methods
Systematic searches until June 2008 for publications of community based prevalence studies with bivariate or multivariate analyses of the association between urinary incontinence in women and overweigh/obesity. In addition an attempt was made to identity and assess all relevant longitudinal studies, prospective case series, and trials, whatever design.
Results
There is evidence 3 and some evidence 2 level data to support that in addition to BMI, waist-hip ratio and thus abdominal obesity may be an independent risk factor for incontinence in women. Only a few interventional studies have been carried out to assess the effect of weight reduction on incontinence. Five studies report effect on incontinence after surgical weight reduction procedures, and one study after a weight reduction program, thus giving some level 2 documentation. There are three RCTs which all show reducing incontinence by weight loss (level of evidence 1).
Conclusions
Epidemiological studies document overweight and obesity as an important risk factor for urinary incontinence. There is now valid documentation for weight reduction as a treatment for urinary incontinence in women. Neurourol. Urodynam. 27:749–757, 2008, © 2008 Wiley-Liss, Inc.
264 citations
References
More filters
TL;DR: The previous European Association of Urology (EAU) guidelines on urinary incontinence comprised a summary of sections of the 2009 International Consultation on Incontinence as mentioned in this paper, and a decision was made in 2010 to rewrite these guidelines based on an independent systematic review carried out by the EAU guidelines panel.
351 citations
01 Jan 2017
TL;DR: was included in the ICI 5 edition PFMT (24) vs PFMT + resistance device (28) 52 Women with SUI or MUI (stress predominant) PFMT: 5 quick and 5 slow (sustained), high-intensity contractions daily.
Abstract: was included in the ICI 5 edition PFMT (24) vs PFMT + resistance device (28) 52 Women with SUI or MUI (stress predominant) PFMT: As below without device PFMT +resistance; 5 quick and 5 slow (sustained), high-intensity contractions daily. Advised to hold contractions as long as possible, relaxing their PFM for an equivalent time before repeating the process. Intravaginal resistance: instructions to use the Pelvic-Toner Device concurrently whilst exercising. Two clinic visits and one phone call Reported cure (based on the Q11 of the ICIQFluts) PFMT 0/13 PFMT+resistance 1/15 Non-sign. difference btw groups (p=0.429) Improvement (post-Tx) PFMT 10/19 PFMT+resistance 11/21 Non-sign. difference btw groups 16 weeks of treatment, outcomes assessed at post-Tx and at 6 month follow-up Dropouts (at 6 month) PFMT 9/24 PFMT + resistance 15/28
338 citations
TL;DR: A systematic review of the literature on urinary incontinence and participation in sport and fitness activities with a special emphasis on prevalence and treatment in female elite athletes finds there is a need for more basic research on pelvic floor muscle function during physical activity and the effect of pelvic floor Muscle training inFemale elite athletes.
Abstract: Urinary incontinence is defined as “the complaint of any involuntary leakage of urine” and is a common problem in the female population with prevalence rates varying between 10% and 55% in 15- to 64-year-old women. The most frequent form of urinary incontinence in women is stress urinary incontinence, defined as “involuntary leakage on effort or exertion, or on sneezing or coughing”. The aim of this article is to systematically review the literature on urinary incontinence and participation in sport and fitness activities with a special emphasis on prevalence and treatment in female elite athletes. Stress urinary incontinence is a barrier to women’s participation in sport and fitness activities and, therefore, it may be a threat to women’s health, self-esteem and well-being. The prevalence during sports among young, nulliparous elite athletes varies between 0% (golf) and 80% (trampolinists). The highest prevalence is found in sports involving high impact activities such as gymnastics, track and field, and some ball games. A ‘stiff’ and strong pelvic floor positioned at an optimal level inside the pelvis may be a crucial factor in counteracting the increases in abdominal pressure occurring during high-impact activities. There are no randomised controlled trials or reports on the effect of any treatment for stress urinary incontinence in female elite athletes. However, strength training of the pelvic floor muscles has been shown to be effective in treating stress urinary incontinence in parous females in the general population. In randomised controlled trials, reported cure rates, defined as <2g of leakage on pad tests, varied between 44% and 69%. Pelvic floor muscle training has no serious adverse effects and has been recommended as first-line treatment in the general population. Use of preventive devices such as vaginal tampons or pessaries can prevent leakage during high impact physical activity. The pelvic floor muscles need to be much stronger in elite athletes than in other women. There is a need for more basic research on pelvic floor muscle function during physical activity and the effect of pelvic floor muscle training in female elite athletes.
319 citations
Journal Article•
TL;DR: In this article, the prevalence of the symptom of urinary incontinence during athletic endeavors among a group of nulliparous, elite college varsity female athletes was found to be high.
265 citations
TL;DR: To review the epidemiological literature of urinary incontinence with respect to overweight and obesity as a risk factor, and how the findings eventually fulfill general criteria for being a causal factor for the condition.
Abstract: Aims
To review the epidemiological literature of urinary incontinence with respect to overweight and obesity as a risk factor, and how the findings eventually fulfill general criteria for being a causal factor for the condition. Likewise to review all interventional studies assessing the effect of weight reduction on incontinence.
Methods
Systematic searches until June 2008 for publications of community based prevalence studies with bivariate or multivariate analyses of the association between urinary incontinence in women and overweigh/obesity. In addition an attempt was made to identity and assess all relevant longitudinal studies, prospective case series, and trials, whatever design.
Results
There is evidence 3 and some evidence 2 level data to support that in addition to BMI, waist-hip ratio and thus abdominal obesity may be an independent risk factor for incontinence in women. Only a few interventional studies have been carried out to assess the effect of weight reduction on incontinence. Five studies report effect on incontinence after surgical weight reduction procedures, and one study after a weight reduction program, thus giving some level 2 documentation. There are three RCTs which all show reducing incontinence by weight loss (level of evidence 1).
Conclusions
Epidemiological studies document overweight and obesity as an important risk factor for urinary incontinence. There is now valid documentation for weight reduction as a treatment for urinary incontinence in women. Neurourol. Urodynam. 27:749–757, 2008, © 2008 Wiley-Liss, Inc.
264 citations