UROGENITAL DISTRESS IN CROATIAN FEMALE ATHLETES - A PILOT CROSS-SECTIONAL OBSERVATIONAL STUDY

I. Lončarić Kelečić¹, E. Uršej¹

¹Alma Mater Europaea - ECM, Physiotherapy, Maribor, Slovenia

Background: Urinary incontinence (UI) in female athletes is growing globally. Research into UI in females has been generally neglected in Croatia.

Purpose: The purpose was to examine the existence of UI in Croatian female athletes and its relationship with their sociodemographic, anthropometric and medical characteristics, as well as with the aspects of competitive sport.

Methods: An anonymous online Google survey, distributed to female athletes through social networks in May 2022, collected their sociodemographic, anthropometric and medical data and general characteristics of sport. TheIncontinence Questionnaire-Urinary Incontinence Short Form(ICIQ-UI SF) was used simultaneously. We analysed 70 complete responses out of 76 received with the PSPP program using chi-square test, t-test and analysis of variance with a defined significance level of p<0.05.

Results: The average age of 70 females competing in 12 different sports was 22.64±4.55. Respondents had a normal Body Mass Index (22.22±2.50), 97.1% of them were nulliparous, with a prevalence of constipation at 11.4% and urinary tract problems at 8.6%, primarily non-oral contraceptives users (78.6%), non-smokers (80.0%) and with no history of epidural/spinal anaesthesia (81.4%). Females who entered competitive sports at the age of puberty (9.52±2.85 years) now compete at national (45.71%), world (41.43%), and international/European (12.86%) levels with professional experience of 7.41±4.29 years. On average, they train 2.84±1.42 hours a day, 5.56±2.64 days a week, out of which 2.25±2.24 hours with weights, and practice additional moderate to vigorous physical activity on 1.80 ±1.71 days a week. On average, they compete 0.94±0.53 times per week and 3.17±1.43 times per month, rest 14.44±9.45 hours per day and 4.74±2.77 weeks per year. The presence of UI in the total sample was 24.3%: 8 (29.6%) handball players, 3 (42.9%) tennis players, 2 (40%) water polo players, one (14.3%) synchronized swimmer, 7 soccer players (14.3%), one weightlifter (50%) and the only swimmer who participated (100%). According to ICIQ-UI SF, in 70.59% of athletes with UI a small amount of urine mostly leaks approximately once a week or less often, in 23.52% it leaks 2 to 3 times a week and in 5.89% once a day. Urine leaks mainly after urination and dressing up (35.29%), when coughing and sneezing (29.41%), before getting to the toilet (17.65%), during physical activity (12.76%) and without apparent reasons (5.89%). The interference of UI with quality of life is mild in 70.59% and moderate to severe in 29.4% of athletes with UI. The severity of UI is slight in 47% and moderate in 53%. Smokers report UI to a greater extent (χ2(1, n=70)=4.666, p<0.05) while other sports and respondents’ characteristics didn’t yield significant findings.

Conclusions: UI is present in a quarter of examined Croatian female athletes and it seems to be associated with smoking. Future research should include a larger number of athletes and strive for greater homogeneity of the subgroups.

Implications: Our findings contribute to sports physiotherapy and are applicable in the context of UI assessment in females and counselling on smoking cessation as a proven UI risk.

Funding acknowledgements: The work was unfunded.

Keywords:
Female athlete
Sports physiotherapy
Urinary incontinence

Topics:
Sport & sports injuries
Pelvic, sexual and reproductive health
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? No

Reason: In our research we used only online survey, which didn't include any questions that would require ethics approval. By participating in a survey all participants agreed for their data to be used in a research. The study is in line with the principles established by national and international regulations, including the Declaration of Helsinki and the Code of Ethics. All personal data was handled following Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016, and the national Organic Law 3/2018, of December 5.