DOES PROLONGED HIGH-IMPACT ACTIVITY CONTRIBUTE TO LATER URINARY-INCONTINENCE - A RETROSPECTIVE COHORT STUDY OF FEMALE OLYMPIANS

Objective: To determine whether women engaged in strenuous, provocativ e exercise are more likely to be incontinent in future life than simil arly fit women who participated in less provocative exercise. Methods: In this retrospective cohort study, female American Olympians who com peted in swimming (low-impact group) and in gymnastics and track and f ield (high-impact group) between 1960 and 1976 completed a structured questionnaire. Primary outcome measures included the prevalence of the symptoms of stress and urge incontinence. Statistical analyses of res ults included chi(2), Fisher exact test, two-tailed t tests, Wilcoxon rank sum test, and stepwise multiple logistic regression. P < .05 was considered significant. Results: One hundred four women responded (res ponse rate 51.2%). High-impact athletes were older (46.2 compared with 42.4 years) and were more likely to report incontinence when they wer e doing their sport as Olympians (35.8% compared with 4.5%) than low-i mpact athletes; law-impact athletes were more likely to be parous (83. 3% compared with 60.7%). There was no difference in the prevalence of the symptom of stress incontinence between the high-versus low-impact groups: any incontinence, 41.1% compared with 50%; daily or weekly inc ontinence, 10.7% compared with 8.3%; and incontinence that bothered th em moderately or greatly, 10.7% compared with 4.2%. With our sample si ze, this study had 80% power to detect a fourfold difference in daily or weekly incontinence between groups, but only a 30% power to detect a twofold difference, given a baseline prevalence of 10%. When age, bo dy mass index (BMI), parity, Olympic sport group, and incontinence dur ing Olympic sport were entered into stepwise logistic regression analy ses, only BMI was significantly associated with regular stress or urge incontinence symptoms. Conclusion: Participation in regular, strenuou s, high-impact activity when younger did not predispose women to a mar kedly higher rate of clinically significant urinary incontinence in la ter life. (C) 1997 by The American College of Obstetricians and Gyneco logists.