Physical activity reduces urinary incontinence in women

Regularly engaging in moderate physical activity reduces urinary incontinence in women, according to study findings shared during the 2021 AUA Annual Meeting.¹

Women in the study who participated in moderate recreational activity had a lower likelihood of experiencing stress urinary incontinence (SUI) or urge urinary incontinence ([UUI]; odds ratio, 0.79 and 0.66, respectively).

Sanam Ladi Seyedian, MD

“Urinary incontinence is a significant source of morbidity among women in the United States. Studies have found that the risk of urinary incontinence is lower in individuals who engage in physical activity or minimize a sedentary lifestyle,” said co-author Sanam Ladi Seyedian, MD, research fellow, Department of Urology, Keck School of Medicine, University of Southern California.

To investigate the relationships between urinary incontinence and physical activity, the investigators looked at the National Health and Nutrition Examination Survey (NHANES). These cycles show self-reported data over a period of 10 years (2008-2018), where participants answered questions about personal experience of urinary incontinence and physical activity. The authors specifically focused on women aged >20 years who participated in this survey

“In the GPAQ [global physical activity questionnaire], physical activity was appraised through several questions assessing work and recreational activity,” explained Seyedian. “Duration of activity was measured as days of a week and minutes of a day. Intensity was assessed as vigorous or moderate. Vigorous physical activity was defined as activities that cause large increases in breathing or heart rate, such as running or carrying a heavy load or digging. Moderate physical activity was defined as activities causing small increase in breathing or heart rate, such as cycling or carrying light loads.”

SUI was defined as “leakage of urine with an activity like coughing, lifting or exercise”; UUI was defined as “leakage of the urine with an urge or pressure to urinate and could not get to the toilet fast enough”; and MUI was defined as “having both stress and urge incontinence” during the 12 months prior to the interview.

Overall, the study included 30,213 women, with 16,541 (54.74%) having urinary incontinence of any type. Of women with urinary incontinence, 23.15% (6996) had SUI, 23.16% (6999) had UUI, and 8.42% (2546) had MUI.

The study used a multivariate logistic regression model, measuring the association between incontinence and physical activity levels after adjusting for age, body mass index, diabetes, race, parity, menopause and smoking.

“Women with urinary incontinence of any type were significantly older, had a higher BMI, and were more likely to suffer from diabetes and to be postmenopausal (P <.001),” said Seyedian. “Women with SUI had a higher number of pregnancies (P <.001). Women with UUI and mixed urinary incontinence (MUI) were more likely to be a smoker (P <.001).”

Detailing the significant findings of the study, Seyedian said, “Women with SUI had a shorter period of moderate recreational activity than those without. Women with UUI and MUI had fewer days of vigorous recreational activity than those without. Women with any type of urinary incontinence had shorter duration of moderate intensity work-related activity. Women with UUI and MUI were sedentary for a greater portion of time.”

While there were significantly fewer reports of SUI and UUI in women who engaged in moderate recreational activity, there were no statistically significant findings that associated incontinence and physical activity in women who engaged in any type of work activity (vigorous or moderate), even though some workplace activities trended toward a relationship.

Additionally, an inverse association between time spent performing moderate intensity activities (both work and leisure) and all 3 types of urinary incontinence was found.

“Moderate physical activity and a 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,” Seyedian concluded. “We hypothesize that the mechanism is multifactorial, with moderate physical activity improving pelvic floor strength and modifying neurophysiological mediators involved in the pathogenesis of incontinence.”

Reference

1. Kim M, Seyedian SL, Ginsberg D, Kreydin E. The association of physical activity and urinary incontinence in women: Results from a multi-year national survey. Paper presented at 2021 American Urological Association Annual Meeting; September 10-13, 2021; virtual. Abstract PD06-03.