CLINICAL ARTICLE Prevalence and impact of urinary incontinence among female athletes Cristina Jácome a , Daniela Oliveira a, ⁎, Alda Marques a , Pedro Sá-Couto b a Higher School of Health, University of Aveiro, Aveiro, Portugal b Center for Research and Development in Mathematics and Applications (CIDMA), University of Aveiro, Aveiro, Portugal abstract article info Article history: Received 5 January 2011 Received in revised form 28 January 2011 Accepted 22 March 2011 Keywords: Female athletes High-impact sports Urinary incontinence Objective: To assess the prevalence of urinary incontinence (UI) in a group of female athletes and to explore its impact on their lives. Methods: In total, 106 female athletics, basketball, and indoor football athletes were recruited. Data were collected through a questionnaire and a focus group and analyzed via Pearson's χ 2 test, 2-way analysis of variance, and thematic analysis. Results: Urinary incontinence was experienced by 41.5% of the athletes. Its prevalence across the 3 types of sport was similar and was not affected by age. However, athletes who experienced UI had a lower body weight (P =0.011) and a lower body mass index (P = 0.035). Most (95.5%) athletes had never discussed their condition with a health professional. In the focus group, all athletes described preventive urination to avoid urine leakage. It was mentioned that UI affected their performance and made them feel uncomfortable and frustrated. Conclusion: Urinary incontinence is a prevalent condition among athletes that is not openly discussed. However, it causes regular changes in their physical performance and daily life. More research is needed to increase awareness of UI and to design interventions. © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. 1. Introduction According to the International Continence Society, urinary incon- tinence (UI) is defined as an involuntary loss of urine [1]. It is a clinical condition that is more prevalent in women than in men, affecting 20–50% of women during the course of their lives, with a higher prevalence in adulthood [2]. Urinary incontinence can be divided into 3 types: stress UI, urge UI, and mixed UI [1]. A higher prevalence of stress UI can be found in young women who practice high-impact sports, specifically in athletes whose activities involve jumping [3–5]. However, its exact prevalence is unknown [5]. Urinary incontinence causes many women to abandon sports to avoid urine loss during exercise [6]. Physiotherapy is effective for the prevention and management of this condition and is widely recommended as a first-line management option, namely through pelvic floor muscle training, which involves strengthening of the pelvic floor muscles [7]. However, the embarrassment that women feel about discussing their condition with health professionals means that UI continues to be underdiagnosed and undertreated [8,9]. Furthermore, measures to prevent UI are not included as a routine part of sports practice [10]. Therefore, athletes with UI symptoms use strategies such as wearing absorbent pads, preventive urination, control of liquid intake, adaptation of their athletic technique, or even a change of sports to minimize the consequences of this condition [4], but they do not commonly seek treatment or professional advice [10,11]. Previous research has shown that UI can have a negative impact on the quality of life of a woman [12–14]. However, little attention has been given to the impact of UI on the daily life of athletes [10]. Therefore, the main aims of the present study were to investigate the prevalence of UI in a group of female athletes, and to explore its impact on their lives by identifying their emotions regarding urine loss and the techniques they use to reduce UI episodes. 2. Materials and methods The present cross-sectional study, carried out between September 15, 2008, and June 19, 2009, applied methodologic triangulation to produce authentic and rich exploratory/descriptive data [15]. Ethics approval was obtained from the ethics representatives or ethics committees of all sports institutions involved in the study. Female athletes involved in athletics (track and field sports— specifically, sprinting, middle-distance running, long-distance run- ning, and jumping), basketball, or indoor football were recruited from sport teams in the central region of Portugal. Athletes were eligible if they were older than 18 years and had been practicing sports for more than 1 year. Athletes older than 45 years and those practicing 2 types of sport were excluded. The total sample comprised 106 athletes. Data were collected via a questionnaire and a focus group interview. The questionnaire contained 3 sections (demographic and sports-related data, urine leakage characterization, and risk factors for UI) and was used to characterize the sample and screen for UI among the athletes. It had previously been submitted to a pre-test with 16 International Journal of Gynecology and Obstetrics 114 (2011) 60–63 ⁎ Corresponding author at: University of Aveiro, Escola Superior de Saúde, Campus Universitário de Santiago, Edifício III, 3810–193, Aveiro, Portugal. Tel.: + 351 234 247 019; fax: +351 234 401 597. E-mail address: danielaoliveira@ua.pt (D. Oliveira). 0020-7292/$ – see front matter © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijgo.2011.02.004 Contents lists available at ScienceDirect International Journal of Gynecology and Obstetrics journal homepage: www.elsevier.com/locate/ijgo