INCONTINENCE IN FEMALE COMPETITIVE SPORTS – A SYSTEMATIC REVIEW

Background: Urinary Incontinence (UI) gains public awareness in populations like pregnant and elderly women. However, this topic is still insufficiently addressed among professional athletes, although recent surveys demonstrate that this subpopulation is particularly affected.

Correlations to specified groups of athletes and disciplines haven been reported in the past decade, pointing out a neglected predicament. The wide-spread assumption that competitive athletes have a strong pelvic floor musculature that functions well, due to their exceptional proprioceptive skills, is contrasted by numerous surveys that reveal frequent pelvic floor disorders in competitive sports.

Objectives: The aim of this study is to illustrate the prevalence of incontinence in female competitive athletes, while, at the same time, deciphering underlying causes, their discipline-specific occurrence, as well as the mutual enhancement of risk-factors.

Method: A systematic literature review has been conducted in order to meet the above mentioned objectives.

Results: Athletes of different disciplines present a varying frequency of incontinence with a prevalence of up to 70% in some disciplines. Increased intensity of pelvic floor-related symptoms leads to the termination of their professional careers in 20% of professional athletes and increases the risk of incontinence in later life. Underlying causes for incontinence are structure, training frequency and strain, hormonal status and psychological health. These factors may not only contribute simultaneously but might interact in the development of UI, as well.

Conclusion: As incontinence has reached too little public perception, it is necessary to address this subject especially in disciplines of high risk for developing pelvic floor disorders. Training programs should incorporate incontinence reducing –and well established preventive measures into training programs.

Moreover, due to the high prevalence in certain disciplines and the mutual enhancement of symptoms, the “Female Athlete Triad” might be extended by the symptom incontinence and thus become the “Female Athlete Tetrad”.