School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Neurourol Urodyn. 2023 Nov;42(8):1733-1744. doi: 10.1002/nau.25274. Epub 2023 Aug 31.
To investigate the differences in pelvic floor muscle (PFM) morphology and function between female runners with and without running-induced stress urinary incontinence (RI-SUI).
This was a cross-sectional, observational study.
Experienced female runners were recruited into two groups: runners who regularly experience RI-SUI (n = 19) and runners who do not (n = 20). Active and passive pelvic floor muscle (PFM) properties were assessed using intravaginal dynamometry during maximal voluntary contractions (MVC) and during passive tissue elongation. The morphology of the urethra and PFMs was assessed using 2D and 3D transperineal ultrasound imaging. Independent t tests or Mann-Whitney U were used as appropriate to test group differences on all study outcomes, and Cohen's d effect sizes were calculated.
The rate of force development during the MVC was significantly higher in participants reporting RI-SUI (p ≤ 0.05) and conversely, significantly lower during passive elongation of the PFMs (p ≤ 0.05) compared to runners with no history of leakage. Concurrently, the extent of bladder neck elevation between rest and maximum voluntary activation was significantly higher among those with RI-SUI compared to those without. Although not significant, small to moderate effect sizes were observed for other outcomes-active force outcomes measured during MVC tended to be higher in runners with RI-SUI, while passive force outcomes measured during passive tissue elongation tended to be lower. The cross-sectional area of the urethral wall and the area of the levator hiatus tended to be larger in runners with RI-SUI compared to those without.
Runners who experience RI-SUI demonstrate better PFM contractile function but lower passive support when compared to their continent counterparts.
研究有和无跑步相关压力性尿失禁（RI-SUI）的女性跑步者盆底肌（PFM）形态和功能的差异。
这是一项横断面、观察性研究。
招募有经验的女性跑步者分为两组：经常经历 RI-SUI 的跑步者（n=19）和不经历 RI-SUI 的跑步者（n=20）。在最大自主收缩（MVC）期间和被动组织拉伸期间，使用阴道内动态测压法评估主动和被动 PFM 特性。使用二维和三维经会阴超声成像评估尿道和 PFM 的形态。使用独立样本 t 检验或曼-惠特尼 U 检验比较所有研究结果的组间差异，并计算 Cohen's d 效应量。
报告有 RI-SUI 的参与者在 MVC 期间的力发展速度明显更高（p≤0.05），相反，在 PFM 被动拉伸期间明显更低（p≤0.05），与没有漏尿史的跑步者相比。同时，在最大自主激活时，膀胱颈抬高的程度在有 RI-SUI 的参与者中明显高于无 RI-SUI 的参与者。虽然没有统计学意义，但对于其他结果，即 MVC 期间测量的主动力结果在有 RI-SUI 的跑步者中倾向于更高，而在被动组织拉伸期间测量的被动力结果倾向于更低，观察到小到中等的效应量。尿道壁的横截面积和提肌裂孔的面积在有 RI-SUI 的跑步者中倾向于大于无 RI-SUI 的跑步者。
与无尿失禁的跑步者相比，有 RI-SUI 的跑步者的 PFM 收缩功能更好，但被动支撑力较低。
