Since 1994 when the first study of urinary incontinence (UI) among female athletes was done, there has been a steadily increasing interest in this area of research. To date, 36 studies focus on urinary incontinence among female athletes, primarily elite athletes. Among the 34 studies focused on athletic incontinence, a variety of instruments have been used to assess key components of the athletic incontinence dynamic. Most studies used urinary incontinence screening tools which were designed for use in general clinical work with women (e.g. ICIQ-SF, UDI-6, IIQ, OAB, BFLUTS) and ask about a variety of aspects of incontinence. Several studies assessed the effect of incontinence on quality of life (using I-QOL and KHQ). Some studies asked additional questions about bladder habits, menstrual status, self-management techniques. A few asked about constipation. All of the studies added questions to assess the extent of athletic involvement. This method of patching together validated instruments and home-made questionnaires was used across all studies because no instrument existed which was designed for use with a population of female athletes.
In a recent literature review performed by the authors, the 17 instruments used across these studies were compared and critiqued. Their advantages and disadvantages were discussed and the literature review concluded that a questionnaire designed to measure the key factors in urinary incontinence in athletics is needed and should include the best traits of the instruments reviewed in this study. The optimal instrument would include measures of: demographics, bladder habits and symptoms, bowel habits and symptoms, degree of involvement in athletics, high risk maneuvers and activities, menstrual status, obstetric history, incontinence during athletics, incontinence during activities of daily living, quality of life, and self management strategies.
In response, the authors have developed a comprehensive instrument in order to consistently assess UI in athletics based on the following five categories: 1) urinary incontinence in athletics, laughter and activities of daily living 2) bowel and bladder habits 3) athletic participation 4) quality of life , and 5) health history. This will allow for standard assessment and discussion of major concepts in future studies, and thorough screening in clinical settings.
The purpose of this paper is to describe the method by which this instrument was developed, validated and tested, and made available for broader use.