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Urinary Incontinence in Women Athletes

Incontinence is the involuntary leakage of urine. When the loss of urine happens during routine activities such as laughing, coughing, sneezing, sex, and exercising (walking, jogging, or running), or lifting something heavy, it is called stress urinary incontinence (SUI).

With mild SUI, pressure may be from sudden forceful activities, like exercise, sneezing, laughing or coughing. If your SUI is more severe, you may also leak with less forceful activities like standing up, walking or bending over. Urinary "accidents" like this can range from a few drops of urine to enough to soak through your clothes.

There are three types of urinary incontinence: urge, stress, and mixed. Urge urinary incontinence is the complaint of “involuntary leakage accompanied by or immediately proceeded by urgency.” Stress urinary incontinence (SUI) is the complaint of “involuntary leakage on effort or exertion” such as coughing, sneezing, laughing, and exercise. Genuine stress incontinence is urodynamically proved involuntary loss of urine when intravesical pressure exceeds that of the urethra without simultaneous detrusor contraction. Mixed urinary incontinence is the complaint of “involuntary leakage associated with urgency and also with exercise, effort, sneezing, and coughing.”

Urinary incontinence affects about 12 million Americans and is more common in women than men. As women age and near the time of menopause, they have reduced levels of estrogen that may cause thinning of the lining of the urethra (the tube that empties urine from your bladder), vaginal tissue become less elastic and the pelvic floor muscles that weaken. These issues can lead to bladder control problems that are quite bothersome. Vaginal delivery is one of the highest risk factors6 for developing urinary incontinence, but prevalence has been observed and measured in nulliparous physically active females.

In female athletes, physical exercise may be a risk factor for UI because of increased intra-abdominal pressure generated during high-impact exercises, which overloads the pelvic organs, predisposing them to U

The proportion of urinary leakage in the different sports was: gymnastics 56%, ballet 43%, aerobics 40%, badminton 31%, volleyball 30%, athletics 25%, handball 21% and basketball 17%

Vaginal delivery is one of the highest risk factors6 for developing urinary incontinence, but prevalence has been observed and measured in nulliparous physically active females. “It can occur during various physical activities, but is especially noted in exercise that involves chronic, repetitive motion and involves high impact landings, jumping, and running.”

Female athletes involved with track and field (long jump, triple jump, high jump [see photo above], hurdles), gymnastics (floor exercises, asymmetric bars, trampolining), basketball, volleyball, handball, combat sports (karate, judo), bodybuilding, and horseback riding are at highest risk, although frequency of SUI is noted in tennis players, skiers, skaters, and joggers.

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