The prevalence of urinary incontinence in nulliparous female sportswomen: A systematic review

Urinary incontinence is the complaint of involuntary loss of urine and is a social and hygienic problem. While pregnancy and delivery have been described as etiological factors, observational studies show that urinary incontinence is also prevalent in nulliparous female athletes. Therefore, the general belief that physically fit women have stronger pelvic floor muscles preventing them from developing urinary incontinence may be questioned. The aim of this study was to systematically review studies investigating the prevalence of urinary incontinence in nulliparous female athletes. The electronic databases Medline, Embase, Cinahl, and Cochrane Library were systematically searched for eligible studies. Two independent researchers assessed the quality of the included studies and extracted the data in a standardised data extraction spreadsheet. Twenty-three studies were included in this systematic review. The urinary incontinence prevalence measured during sport activity varied from 5.7% to 80%. Urinary incontinence prevalence differs based on the type of sport. Trampolinists were found to have the highest prevalence of urinary incontinence. The findings suggest that urinary incontinence occurs often in female athletes, especially those involved in high impact sports. Future studies should investigate the mechanisms by which high impact sport activities may affect pelvic floor muscles leading to the development of urinary incontinence.