Urinary Incontinence and Levels of Regular Physical Exercise in Young Women.

The purpose of this study was to determine the influence of different levels of regular physical exercise on the frequency of urinary incontinence in young nulliparous women from the northern region of Portugal. Participants (n=386) self-reported demographic variables, frequency, and time spent practicing organized exercise per week, as well as completed the International Consultation on Incontinence Questionnaire-Short Form. The level of exercise was calculated based on the time (in minutes) usually spent per week in organized exercise. 19.9% of Portuguese nulliparous women reported incontinence symptoms. Considering the distribution of urinary incontinence among the different quartiles of organized exercise, women from the 4(th)quartile (those who train for competitive purposes) demonstrated highest relative frequency (p=0.000) and a 2.53 greater relative risk to develop (95% CIs,1.3-2.7) incontinence compared to women from the 1(st) quartile (inactive). Women who practice exercise for recreational purposes (2(nd) and 3(rd) quartiles) did not show significant differences in the urinary incontinence prevalence and relative risk of developing it compared to women from the 1(st) quartile. The results showed that women participating in organized exercise involving high volume training for competition are potentially at risk of developing urinary incontinence, although organized exercise undertaken without the intent to compete seems to be safe for maintaining urinary continence.

Do asymptomatic former high-impact sports practitioners maintain the ability to contract the pelvic floor muscles?

AIM: Sports are associated with pelvic floor dysfunction. This work aimed to assess, in nulliparous asymptomatic women, whether previous intense practice of high-impact sports is associated with differences in morphology and contraction of the pelvic floor muscles, when compared to women who practiced low-level physical activity. METHODS: In this prospective pilot study, 7 former high-impact sports practitioners and a control group (N.=7) were compared. Clinical evaluation and self-administered questionnaires were used to gather information about pelvic floor dysfunction and physical activity. Static and cine dynamic MR images were acquired. Morphological measures of the pubovisceral muscle area and thickness, and levator hiatus (LH) anterior-to-posterior diameter, width and area were taken in the static images. LH anterior-to-posterior diameter was again assessed in the dynamic acquisition (consecutive blocks of rest vs. maximal voluntary contraction). The relative variation between these two conditions was used as an indirect measure of contraction. RESULTS: No abnormal clinical or imaging findings were reported. Former high-impact sports practitioners evidenced decreased pubovisceral muscle thickness (right side P=0.005; left side P=0.004) and area (P=0.004), and larger levator hiatus width and area (P=0.045; P=0.005). Only its anterior-to-posterior diameter was similar (4.89cm±0.35 and 4.81cm±0.17, respectively). Their ability to perform maximum voluntary contractions seems to have decreased (8.03%±0.81 vs. 13.74%±0.95 for controls). CONCLUSION: The current results suggest that women who previously practiced high-impact sports, even being asymptomatic, may have suffered damage to the pelvic floor muscles due to the biomechanical impact of the sports. They may require pelvic floor muscle training to increase muscle thickness and hiatal closing capacity.

Oxford Grading Scale vs manometer for assessment of pelvic floor strength in nulliparous sports students.

OBJECTIVES: To compare pelvic floor muscle strength in nulliparous sports students measured using the modified Oxford Grading Scale and a Peritron manometer; and to compare the manometric measurements between continent and incontinent subjects. DESIGN: Cross-sectional study. All subjects were evaluated twice on the same day; first by vaginal digital examination and subsequently by vaginal pressure using a Peritron manometer. PARTICIPANTS: Forty-three nulliparous female sports students [mean age 21 (standard deviation 4) years] from the Sports Faculty of the University of Porto. RESULTS: This study found a significant moderate correlation between the Oxford Grading Scale score and peak pressure on manometry (r=0.646, P=0.002). Mean maximal strength for the entire group was 70.4cmH2O (range 21 to 115cmH2O). Out of 43 subjects, 37% (n=16) demonstrated signs of incontinence. On manometry, no significant differences were found in vaginal resting pressure or peak pressure between the continent and incontinent groups. CONCLUSIONS: There was moderate correlation between peak pressure on manometry and the Oxford Grading Scale score. Peritron manometer measurements of pelvic floor muscle contractions showed no significant differences in vaginal resting pressure and peak pressure in continent and incontinent subjects.