Stress urinary incontinence (SUI) has been shown to affect almost half of women who attend gyms or exercise classes [1,2].  Women who continue to exercise or take part in sporting activities may describe discomfort, reduced levels of enjoyment, embarrassment and loss of confidence. Vaginal devices are an appropriate management option for this cohort of women, especially those who wish to avoid surgery for incontinence [3].  Research on incontinence devices is limited and has typically focussed on clinical parameters such as pad tests, rather than long-term compliance and patient reported outcomes.The Uresta bladder support is an effective management option for women with stress urinary incontinence (SUI), however, there is a lack of data assessing long-term compliance. The aim of this study was to assess compliance at 12 month follow-up in women using the Uresta bladder support for exercise related SUI.

This was a prospective study of the Uresta bladder support in women who reported SUI during exercise in the United Kingdom. The study was advertised on social media, running clubs and gyms.  Participants were fitted with a Uresta bladder support and followed up over a 12 month period.   Power calculation recommended a sample size of 43.  Ethical approval was obtained.  Outcomes were assessed using the PUQ, ICIQ-FLUTS, UDI-6, IIQ-7, QUID and PGI-I questionnaires.

Forty-six women were recruited with an average age, BMI and parity of 42, 24 and 2.3 respectively.  The most common activities were running (48%) and CrossFit (22%).  Six participants withdrew after 2 weeks.  Compliance was 90% at 12 months (n=40).  Uresta insertion was 'okay', 'easy' or 'very easy' for 86% of participants and removal was 'okay', 'easy' or 'very easy' for 75% of participants, Leakage was improved (n=13), greatly improved (n=12) or stopped (n=5) for 83% of participants, 75% were ‘much better’ or ‘very much better’ on the PGI-I scale, and 94% would recommend Uresta to a friend.  There were no adverse events.

The Uresta bladder support is a safe, effective, user-friendly management option for women who experience SUI during exercise with excellent long-term compliance.  Future studies should identify predictors of successful fitting with incontinence devices and compare the efficacy, ease of use, compliance and cost-effectiveness between different devices currently available.  Furthermore, development of a specific, validated questionnaire assessing impact of SUI with exercise and impact of incontinence devices would be a valuable resource for future research in this area.

The Uresta bladder support is a safe, effective, user-friendly management option for women with exercise related SUI with 90% compliance at 12-month follow up.

McKenzie S, Watson T, Thompson J, Briffa (2016) Stress urinary incontinence is highly prevalent in recreationally active women attending gyms or exercise classes. Int Urogynecol J;27(8):1175-84.
Yang J, Cheng JW, Wagner H, Lohman E, Yang SH, Krishingner GA et al (2019) The effect of high impact crossfit exercises on stress urinary incontinence in physically active women. Neurourol Urodyn;38(2):749–56
Urinary incontinence and pelvic organ prolapse in women: management. NICE guideline [NG123] Published 02 April 2019.

Continence 2S2 (2022) 100197
DOI: 10.1016/j.cont.2022.100197