Stress urinary incontinence prevalence and risk factors in female rugby players: a common health problem across four nations

Objectives Female athletes engaging in high-impact sports have a higher prevalence of experiencing stress urinary incontinence (SUI). However, the prevalence of sport-specific SUI and associated risk factors in female rugby players is relatively unknown. We aimed to determine the prevalence of general and rugby-related SUI and identify associated risk factors and inciting events in female rugby players. Methods Observational, cross-sectional study of 396 female rugby players (age 28±8 years, mass 80±18 kg, height 1.90±0.19 m, playing years 7±6 years) participating in rugby across UK and Ireland completed an electronic questionnaire regardless of SUI status. Results 63 to 88% of players had SUI, and 43% had rugby-related SUI. There was an association with players reporting a change in incontinence status due to playing rugby (p<0.001). Players who experienced constipation (OR 2.33 (95% CI 1.49 to 3.66)), had given birth (OR 2.36 (95% CI 1.18 to 4.73)) or who had a higher body mass index (BMI) (OR 1.04 (95% CI 1.01 to 1.08)), were identified as having increased odds of rugby-related SUI. For rugby-specific risk factors, playing as a forward (OR 1.97 (95% CI 1.29 to 3.01)) increased the odds, whereas playing at a national compared with amateur level (OR 0.44 (95% CI 0.20 to 0.97)) decreased the odds of rugby-related SUI. The most prevalent inciting SUI events were being tackled (75%), tackling (66%), running (63%) and jumping/landing (59%). Conclusion Rugby-related SUI was prevalent in female rugby players. Risk factors were having constipation, a high BMI, being postpartum, playing position and level. Player welfare strategies addressing pelvic floor dysfunction and postpartum rehabilitation are warranted.