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The Association of Physical Activity and Urinary Incontinence in US Women: Results from a Multi-Year National Survey

Published:October 09, 2021DOI:https://doi.org/10.1016/j.urology.2021.09.022

      Abstract

      Objectives

      To evaluate the relationships between physical activity, both work and recreational, and urinary incontinence among women.

      Methods

      We assessed women aged 20 years and older in 2008-2018 NHANES (National Health and Nutrition Examination Survey) cycles who answered self-reported urinary incontinence and physical activity questions. Weighted, multivariate logistic regression model was used to determine the association between incontinence and physical activity levels after adjusting for age, body mass index, diabetes, race, parity, menopause and smoking.

      Results

      A total of 30,213 women were included in analysis, of whom 23.15% had stress incontinence, 23.16% had urge incontinence, and 8.42% had mixed incontinence (answered “yes” to both stress and urge incontinence). Women who engaged in moderate recreational activity were less likely to report stress and urge incontinence (OR 0.79, 95% CI 0.62-0.99 and OR 0.66, 95% CI 0.48-0.90, respectively). Similarly, women who engaged in moderate activity work were less likely to report stress, urge and mixed incontinence (OR 0.84, 95% CI 0.70-0.99; OR 0.84, 95% CI 0.72-0.99; and OR 0.66 95% CI 0.45-0.97, respectively).

      Conclusions

      Moderate physical activity and greater time spent participating in moderate physical activity are associated with a decreased likelihood of stress, urge and mixed incontinence in women. This relationship holds for both recreational and work-related activity. We hypothesize that the mechanism of this relationship is multifactorial, with moderate physical activity improving pelvic floor strength and modifying neurophysiological mediators (such as stress) involved in the pathogenesis of incontinence.
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      References

        • Pedersen BK
        • Saltin B.
        Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases.
        Scand J Med Sci Sports. 2015; 25 (Suppl 3): 1-72
        • Jerez-Roig J
        • Booth J
        • Skelton DA
        • Giné-Garriga M
        • Chastin SFM
        • Hagen S.
        Is urinary incontinence associated with sedentary behaviour in older women? Analysis of data from the National Health and Nutrition Examination Survey.
        PLoS One. 2020; 15e0227195
        • Danforth KN
        • Shah AD
        • Townsend MK
        • et al.
        Physical activity and urinary incontinence among healthy, older women.
        Obstet Gynecol. 2007; 109: 721-727
        • Nygaard IE
        • Shaw JM.
        Physical activity and the pelvic floor.
        Am J Obstet Gynecol. 2016; 214: 164-171
        • Thyssen HH
        • Clevin L
        • Olesen S
        • Lose G.
        Urinary incontinence in elite female athletes and dancers.
        Int Urogynecol J Pelvic Floor Dysfunct. 2002; 13: 15-17
        • Brown JS
        • Wing R
        • Barrett-Connor E
        • et al.
        Lifestyle intervention is associated with lower prevalence of urinary incontinence: the diabetes prevention program.
        Diabetes Care. 2006; 29: 385-390
        • Zipf G
        • Chiappa M
        • Porter KS
        • Ostchega Y
        • Lewis BG
        • Dostal J.
        National health and nutrition examination survey: plan and operations, 1999-2010.
        Vital Health Stat. 2013; 1: 1-37
        • World Health Organization (WHO)
        Global Physical Activity Questionnaire (GPAQ).
        World Health Organization (WHO), Geneva, Switzerland2011 (Available at) (Accessed June 12, 2013)
        • Nygaard I
        • Barber MD
        • Burgio KL
        • et al.
        Prevalence of symptomatic pelvic floor disorders in US women.
        Jama. 2008; 300: 1311-1316
        • Wu JM
        • Vaughan CP
        • Goode PS
        • et al.
        Prevalence and trends of symptomatic pelvic floor disorders in U.S. women.
        Obstet Gynecol. 2014; 123: 141-148
        • Kruger J
        • Budgett D
        • Goodman J
        • Bø K.
        Can you train the pelvic floor muscles by contracting other related muscles?.
        Neurourol Urodyn. 2019; 38: 677-683
        • Kruger JA
        • Murphy BA
        • Heap SW.
        Alterations in levator ani morphology in elite nulliparous athletes: a pilot study.
        Aust N Z J Obstet Gynaecol. 2005; 45: 42-47
        • Kruger JA
        • Dietz HP
        • Murphy BA.
        Pelvic floor function in elite nulliparous athletes.
        Ultrasound Obstet Gynecol. 2007; 30: 81-85
        • Jürgensen SP
        • Borghi-Silva A
        • Bastos A
        • et al.
        Relationship between aerobic capacity and pelvic floor muscles function: a cross-sectional study.
        Braz J Med Biol Res. 2017; 50: e5996
        • Bø K
        • Ellstrøm Engh M
        • Hilde G
        Regular exercisers have stronger pelvic floor muscles than nonregular exercisers at midpregnancy.
        Am J Obstet Gynecol. 2018; 218 (427.e421-427.e425)
        • Bø K
        • Nygaard IE.
        Is physical activity good or bad for the female pelvic floor? a narrative review.
        Sports Med. 2020; 50: 471-484
        • Nygaard IE
        • Shaw JM
        • Bardsley T
        • Egger MJ.
        Lifetime physical activity and female stress urinary incontinence.
        Am J Obstet Gynecol. 2015; 213 (40.e41-40.e10)
        • Coyne KS
        • Sexton CC
        • Clemens JQ
        • et al.
        The impact of OAB on physical activity in the United States: results from OAB-POLL.
        Urology. 2013; 82: 799-806
        • Sanford MT
        • Rodriguez LV.
        The role of environmental stress on lower urinary tract symptoms.
        Curr Opin Urol. 2017; 27: 268-273
        • Lai H
        • Gardner V
        • Vetter J
        • Andriole GL.
        Correlation between psychological stress levels and the severity of overactive bladder symptoms.
        BMC Urol. 2015; 15: 14
        • Sanford MT
        • Yeh JC
        • Mao JJ
        • et al.
        Voluntary exercise improves voiding function and bladder hyperalgesia in an animal model of stress-induced visceral hypersensitivity: A multidisciplinary approach to the study of urologic chronic pelvic pain syndrome research network study.
        Neurourol Urodyn. 2020; 39: 603-612