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

• Published in: Scandinavian journal of medicine & science in sports 2016-09, Vol.26 (9), p.1109-1116
• Main Authors: Almeida, M. B. A., Barra, A. A., Saltiel, F., Silva-Filho, A. L., Fonseca, A. M. R. M., Figueiredo, E. M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; anal incontinence; Brazil - epidemiology; Constipation - epidemiology; Cross-Sectional Studies; dyspareunia; Dyspareunia - epidemiology; epidemiology; Fecal Incontinence - epidemiology; Female; Female athletes; Females; Gymnastics - statistics & numerical data; Health Surveys; Humans; Martial Arts - statistics & numerical data; pelvic floor dysfunction; pelvic organ prolapse; Pelvic Organ Prolapse - epidemiology; Sports - statistics & numerical data; Sports medicine; Swimming - statistics & numerical data; Urinary incontinence; Urinary Incontinence - epidemiology; vaginal laxity; Volleyball - statistics & numerical data; women's health; Young Adult
• ISSN: 0905-7188; 1600-0838
• DOI: 10.1111/sms.12546

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.