1. Women experiencing stress urinary incontinence were more likely to report a higher overall amount of lifetime physical activity.
2. Women suffering from stress urinary incontinence were more likely to have engaged in higher levels of strenuous activity as teenagers.
Evidence Rating Level: 3 (Average)
Study Rundown: Stress urinary incontinence (SUI), the involuntary leakage of urine when intra-abdominal pressure is increased, can arise from inadequate pelvic organ support. SUI, which affects up to one-third of women, negatively affects quality of life and impact women’s social, emotional and physical health. Risk factors for SUI include parity, aging and obesity. First-line treatments include pelvic floor physical therapy, temporizing measures such as pessaries and definitive treatment via surgery. Previous research evaluating behaviors associated with SUI suggest that regular low-intensity activity appears associated with a decreased likelihood of SUI in middle-aged women. In the present work, authors explored the impact of physical activity over the course of a woman’s life on risk of developing SUI. Results indicated that higher levels of overall lifetime activity and more strenuous activity during teenage years were associated with increased odds of SUI.
These findings should not be used to discourage women from exercise, particularly given the known association between obesity and stress incontinence, but rather to improve identification of women who may be at an increased risk for developing SUI. The principal strength of this study was a community-based study population. Weaknesses included case-control design, recall bias due to exposure ascertainment via retrospective self-reported data, and a predominantly Caucasian cohort. Prospective cohort studies to further evaluate the relationship between physical activity and SUI are needed.
Relevant Reading: Physical activity and urinary incontinence among healthy older women
In-Depth [case-control study]: This study evaluated the relationship between lifetime physical activity and SUI in women aged 39 to 65 years. Women scoring ≥3 on the Incontinence Severity Index were classified as cases of moderate or severe SUI (n=226); age-matched women scoring ≤2 were classified as controls (n=226). Exposures of interest included overall lifetime activity, lifetime leisure activity, lifetime strenuous activity and teenage strenuous activity.
Overall lifetime activity was associated with an increased likelihood of SUI (OR=1.20, CI: 1.02-1.41) for each 70 additional MET-hours/week. Women who engaged in more strenuous activity as teenagers were more likely to experience SUI (OR=1.37, CI: 1.09-1.71) for every additional 7 hours/week, with a linear relationship among women who engaged in more than 7.5 hours/week of strenuous activity as teens.
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