scholarly journals Benefits of Physiotherapy on Urinary Incontinence in High-Performance Female Athletes. Meta-Analysis

2020 ◽  
Vol 9 (10) ◽  
pp. 3240
Author(s):  
Alba Sorrigueta-Hernández ◽  
Barbara-Yolanda Padilla-Fernandez ◽  
Magaly-Teresa Marquez-Sanchez ◽  
Maria-Carmen Flores-Fraile ◽  
Javier Flores-Fraile ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Floor ◽  
High Performance ◽  
Female Athletes ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Pelvic Floor Dysfunction ◽  
Urinary Continence ◽  
Control Group ◽  
Aerobic Activity

Introduction: High performance female athletes may be a risk group for the development of urinary incontinence due to the imbalance of forces between the abdomen and the pelvis. Pelvic floor physiotherapy may be a useful treatment in these patients. Objectives: (1) To identify the scientific evidence for pelvic floor (PF) dysfunctions that are associated with urinary incontinence (UI) in high-performance sportswomen. (2) To determine whether pelvic floor physiotherapy (PT) corrects UI in elite female athletes. Materials and methods: Meta-analysis of published scientific evidence. The articles analyzed were found through the following search terms: (A) pelvic floor dysfunction elite female athletes; (B) urinary incontinence elite female athletes; (C) pelvic floor dysfunction elite female athletes physiotherapy; (D) urinary incontinence elite female athletes physiotherapy. Variables studied: type of study, number of individuals, age, prevalence of urinary incontinence described in the athletes, type of sport, type of UI, aspect investigated in the articles (prevalence, response to treatment, etiopathogenesis, response to PT treatment, concomitant health conditions or diseases. Study groups according to the impact of each sport on the PF: G1: low-impact (noncompetitive sports, golf, swimming, running athletics, throwing athletics); G2: moderate impact (cross-country skiing, field hockey, tennis, badminton, baseball) and G3: high impact (gymnastics, artistic gymnastics, rhythmic gymnastics, ballet, aerobics, jump sports (high, long, triple and pole jump)), judo, soccer, basketball, handball, volleyball). Descriptive analysis, ANOVA and meta-analysis. Results: Mean age 22.69 years (SD 2.70, 18.00–29.49), with no difference between athletes and controls. Average number of athletes for each study was 284.38 (SD 373,867, 1–1263). The most frequent type of study was case-control (39.60%), followed by cross-sectional (30.20%). The type of UI was most often unspecified by the study (47.20%), was stress UI (SUI, 24.50%), or was referred to as general UI (18.90%). Studies on prevalence were more frequent (54.70%), followed by etiopathogenesis (28.30%) and, lastly, on treatment (17.00%). In most cases sportswomen did not have any disease or concomitant pathological condition (77.40%). More general UI was found in G1 (36.40%), SUI in G2 (50%) and unspecified UI in G3 (63.64%). In the meta-analysis, elite athletes were found to suffer more UI than the control women. In elite female athletes, in general, physiotherapy contributed to gain in urinary continence more than in control women (risk ratio 0.81, confidence interval 0.78–0.84)). In elite female athletes, former elite female athletes and in pregnant women who regularly engage in aerobic activity, physiotherapy was successful in delivering superior urinary continence compared to the control group. The risk of UI was the same in athletes and in the control group in volleyball female athletes, elite female athletes, cross-country skiers and runners. Treatment with PT was more effective in control women than in gymnastics, basketball, tennis, field hockey, track, swimming, volleyball, softball, golf, soccer and elite female athletes. Conclusions: There is pelvic floor dysfunction in high-performance athletes associated with athletic activity and urinary incontinence. Eating disorders, constipation, family history of urinary incontinence, history of urinary tract infections and decreased flexibility of the plantar arch are associated with an increased risk of UI in elite female athletes. Pelvic floor physiotherapy as a treatment for urinary incontinence in elite female athletes, former elite female athletes and pregnant athletes who engage in regular aerobic activity leads to a higher continence gain than that obtained by nonathlete women.

Meta-analysis of Perinatal Pelvic Floor Muscle Training on Urinary Incontinence

2020 ◽  
pp. 019394592096077
Author(s):  
Ji Lu ◽  
Hong Zhang ◽  
Li Liu ◽  
Wei Jin ◽  
Jie Gao ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle Training ◽  
Pelvic Floor Muscle ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Intervention Group ◽  
Cochrane Library ◽  
Control Group ◽  
Muscle Training

This study was to evaluate the effect of pelvic floor muscle training (PFMT) on urinary incontinence (UI) in prenatal and postnatal women. The relevant literatures were searched from Pubmed, Embase, Cochrane Library, and Web of Science until January 20, 2020. Meta-analysis was performed with STATA 15.1 and the Begg’s test was used for the publication bias. Results of the meta-analysis demonstrated that the rate of UI in the intervention group was lower than that in the control group [relative risk (RR): 0.712, 95%confidence intervals (CI): 0.622–0.816, P<0.001); the strength of pelvic floor muscle in the intervention group was higher than that in the control group [weighted mean difference (WMD): 8.448, 95%CI: 2.300–14.595, P=0.007); and the urine leakage measured by the urinal pad in the intervention group was less than that in the control group (WMD: -1.699, 95%CI:-2.428–-0.970, P<0.001). PFMT showed a better effect for UI than the routine nursing.

Pelvic floor muscle exercise as the best stress urinary incontinence prevention method in women practising competitive sport

Physiotherapy ◽  
2013 ◽  
Vol 21 (2) ◽  
Author(s):  
Józef A. Opara ◽  
Teresa Socha ◽  
Anna Poświata
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Pelvic Floor ◽  
Female Athletes ◽  
Pelvic Floor Muscle ◽  
Abdominal Muscle ◽  
Urinary Continence ◽  
Competitive Sport ◽  
Prevention Method ◽  
Respiratory Exercises

AbstractExercises in stress urinary incontinence (SUI) cover Pelvic Floor Muscle Exercises (PFME), also known in literature as Pelvic Floor Muscle Training (PFMT) or Kegel exercises; isometric exercises, exercises of the abdominal and gluteal muscles and of the adductor of thigh, respiratory exercises carried out through the abdominal tract, exercises in water. In persons with urinary incontinence, the interaction between the pelvic floor muscles and the transverse abdominal muscle is impaired, suggesting a significant role of this muscle in urinary continence. Consequently, a moderate training, e.g. including exercises of Pilates method, may be part of the therapy. Stress urinary incontinence is a frequent occurrence among women practising competitive sport. In the review article we have presented the incidence of stress urinary incontinence in sportswomen, risk factors and physiotherapeutic treatment. We have paid specific attention to the prevention of stress urinary incontinence in female athletes.

scholarly journals Physiotherapy according to the BeBo Concept as prophylaxis and treatment of urinary incontinence in women after natural childbirth

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aneta Śnieżek ◽  
Dorota Czechowska ◽  
Marta Curyło ◽  
Jacek Głodzik ◽  
Paweł Szymanowski ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Physical Therapy ◽  
Pelvic Floor ◽  
Positive Impact ◽  
Pelvic Floor Muscle ◽  
Exercise Program ◽  
Exercise Group ◽  
Urinary Continence ◽  
Control Group ◽  
Natural Childbirth

AbstractPelvic floor muscle dysfunctions can lead to urinary incontinence, a condition which often affects women both during pregnancy and after childbirth. As a result of this, certain exercises are recommended during and after pregnancy to prevent and treat this incontinence, and the BeBo Concept is one of these methods used to prevent pelvic floor muscle dysfunction. The aim of the present study was to evaluate the effects of a 6-week course of physical therapy according to the BeBo Concept on the improvement of perineal muscle strength and endurance as well as urinary continence in women after their first vaginal delivery. The study was conducted on a group of 56 women who were randomly assigned to the exercise (n = 30) or control (n = 26) group. The exercising group participated in a 6-week physical therapy program according to the BeBo Concept. Pelvic floor muscles were assessed using the perineometer and palpation Perfect Test. UDI6 and ICIQ-SF questionnaires were used to obtain information about the symptoms of urinary incontinence, evaluate the frequency, severity and impact of urine leakage on the quality of life. In all women after natural childbirth, regardless of treatment, it was observed that measured parameters improved, but the improvement was slightly more explicit in those who participated in the Bebo Concept exercise group (e.g. ICIQ-SF exercise group p = 0.001, control group p = 0.035). Due to its positive impact on the pelvic floor, this exercise program should be recommended to women after natural childbirth.

scholarly journals Prevalence of Urinary Incontinence in High-Impact Sport Athletes: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 73 (1) ◽  
pp. 279-288
Author(s):  
Telma Pires ◽  
Patrícia Pires ◽  
Helena Moreira ◽  
Rui Viana
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Female Athletes ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
High Impact ◽  
Eligibility Criteria ◽  
Potential Risk Factors ◽  
Black Scale ◽  
Impact Sport

AbstractThe aim of this study was to systematize the scientific evidence that assessed the prevalence of urinary incontinence in female athletes and determine which modality is most predisposed to stress urinary incontinence. From September to December 2018, a systematic literature search of current interventional studies of stress urinary incontinence of the last ten years was performed using PubMed, EMBASE, Scopus and Web of Science databases. The methodological quality was assessed by the Downs and Black scale, while the data collected from the studies were analyzed through meta-analysis. Nine studies met the eligibility criteria, meaning they included reports of urinary incontinence in different sports. The meta-analysis showed 25.9% prevalence of urinary incontinence in female athletes in different sports, as well as 20.7% prevalence of stress urinary incontinence. The most prevalent high impact sport was volleyball, with the value of 75.6%. The prevalence of urinary incontinence can be high in female athletes, with high-impact sports potentially increasing the risk for stress urinary incontinence. Further research is needed regarding the potential risk factors related to the onset of urinary incontinence.

scholarly journals Pelvic Floor Dysfunction, the Role of Imaging and Reconstructive Surgery

2013 ◽  
Vol 7 (1) ◽  
pp. 86-97
Author(s):  
Ahmad G Serour ◽  
Laila A Mousa
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Vaginal Prolapse ◽  
Urinary Continence ◽  
Urethral Pressure ◽  
Childbirth Trauma

ABSTRACT We are putting forward three novel concepts describing the pathophysiology concerning: • Micturition, factors that control urinary continence and different types of urinary incontinence. • Genital organs support and genital prolapse. • Defecation, causes of fecal incontinence (FI). I. Urinary continence depends on high urethral pressure (Pura) which depends upon two factors: One inherent and one acquired. 1. The inherent factor is the tough strong collagen layer constituent of the internal urethral sphincter (IUS), that creates the high wall tension necessary for keeping high urethral pressure (Pura). The IUS is a collagen-muscle tissue cylinder that extends from the bladder neck to the perineal membrane in both sexes. 2. The acquired factor, which is high alpha-sympathetic tone at the IUS gained from learning and training in early childhood, keeps it contracted and the urethra closes all the time until there is a need or a desire to void as social circumstances allow. Injury to one or both factors leads to urinary incontinence. II. The vagina is a cylinder of collagen-elastic-muscle tissues. The strong tough collagen sheet is responsible for the upright position of the vagina. The main function of the pelvic ligaments is to assign the pelvic organs to their anatomical site and keeps the pelvic organs in situ. Childbirth trauma damages the collagen layer due to overstretching of the vagina and leads to flabby and redundant vaginal walls with subsequent vaginal prolapse. When the pelvic ligaments suffer most of the trauma, the insult will lead to weakness of the pelvic ligaments, leading to vault and uterine prolapse. III. The integrity of both anal sphincters, internal anal sphincter (IAS) and external anal sphincter (EAS) is an essential factor in keeping fecal continence. Fecal continence also depends on strong pelvic floor muscles which keep an angle between the rectum and the anal canal. In addition, it depends on an acquired behavior, gained by learning and training in early childhood of maintaining high alpha-sympathetic tone at the IAS keeping the anal canal empty and closed all the time until there is a desire and/or a need to pass flatus and/ or stool and there are favorable social circumstances. The intimate relation of the IUS with the anterior vaginal wall and the IAS with the posterior vaginal wall exposes them to the childbirth trauma with subsequent damage. This will lead to stress urinary incontinence (SUI) and FI in addition to vaginal prolapse. Therefore, we have innovated an operation to treat SUI, FI and vaginal prolapse. ‘Urethro-ano-vaginoplasty’ repair operation. It consists of anterior and posterior sections. In the anterior section, we have corrected the SUI and the anterior vaginal wall descent through the following steps: 1. Expose the IUS and mend its torn wall. 2. Strengthen the anterior vaginal wall by overlapping the two vaginal flaps, and hence we can add extra support to the mended IUS and preserve the body collagen. In the posterior section, we have the following: 1. Exposed the IAS and mended the torn sphincter. 2. We have approximated the two-levator ani muscles. 3. Strengthened the posterior vaginal wall by overlapping the two vaginal flaps; as such, we would have also added extra support to the mended IAS and kept the natural body collagen. 4. We repaired the perineum. How to cite this article El Hemaly AKM, Mousa LA, Kurjak A, Kandil IM, Serour AG. Pelvic Floor Dysfunction, the Role of Imaging and Reconstructive Surgery. Donald School J Ultrasound Obstet Gynecol 2013;7(1):86-97.

scholarly journals Quo Vadis Urogynecology 2020 – Innovative Treatment Concepts for Urinary Incontinence and Pelvic Organ Prolapse

2021 ◽  
Vol 81 (02) ◽  
pp. 183-190
Author(s):  
Gert Naumann
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Professional Training ◽  
Pelvic Floor Dysfunction ◽  
Estrogen Therapy ◽  
Pelvic Organ ◽  
Alloplastic Materials ◽  
Wide Range ◽  
Quo Vadis

AbstractThe current treatment for urinary incontinence and pelvic organ prolapse includes a wide range of innovative options for conservative and surgical therapies. Initial treatment for pelvic floor dysfunction consists of individualized topical estrogen therapy and professional training in passive and active pelvic floor exercises with biofeedback, vibration plates, and a number of vaginal devices. The method of choice for the surgical repair of stress urinary incontinence consists of placement of a suburethral sling. A number of different methods are available for the surgical treatment of pelvic organ prolapse using either a vaginal or an abdominal/endoscopic approach and autologous tissue or alloplastic materials for reconstruction. This makes it possible to achieve optimal reconstruction both in younger women, many of them affected by postpartum trauma, and in older women later in their lives. Treatment includes assessing the patientʼs state of health and anesthetic risk profile. It is important to determine a realistically achievable patient preference after explaining the individualized concept and presenting the alternative surgical options.

scholarly journals Sexual function in women with pelvic floor disorders

2013 ◽  
Vol 7 (9-10) ◽  
pp. 199 ◽  
Author(s):  
Rebecca G. Rogers
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Stress Urinary Incontinence ◽  
Sexual Function ◽  
Pelvic Floor ◽  
Pelvic Floor Disorders ◽  
Pelvic Floor Dysfunction ◽  
Pelvic Organ ◽  
The Impact

Pelvic floor disorders (PFDs) can impact sexual function. This summary provides an overview of the impact of stress urinary incontinence and pelvic organ prolapse and their treatments on sexual function. In general, interventions that successfully address PFDs will generally improve sexual function as well. However, there are patients whose sexual function will remain unchanged despite treatment, and a small but significant minority who will report worsened sexual function following treatment for their pelvic floor dysfunction.

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