Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Health Sciences


Rehabilitation Sciences

First Advisor

Dr. Terry Malone

Second Advisor

Dr. Gilson Capilouto


Urinary incontinence is a health condition that is associated with involuntary leakage of urine. Stress urinary incontinence (SUI) describes involuntary leakage of urine on effort or exertion and can impact one’s ability to participate in activities and affect quality of life. Furthermore, clinical management of this health condition is challenging as individuals who experience urinary incontinence often do not report this concern to a health care provider.

Stress urinary incontinence is not typically a health concern associated with young, healthy athletes. However, researchers have begun to examine the presence of this health condition amongst both a younger population and in athletes. Therefore, the purpose of this study is to assess the prevalence of stress urinary incontinence in collegiate female athletes.

This study involved the development of an electronic survey tool to assess the prevalence of SUI in the female collegiate athlete. Female collegiate athletes from six different NCAA Division I schools were asked to complete the survey. The overall response rate for the survey was 32.6% (333/1020). Results indicate that SUI does in fact occur in NCAA Division I collegiate female athletes. Overall, 68.5% of female collegiate athletes surveyed reported ever experiencing SUI. During daily life activities (cough, sneeze, laugh), 54.2% of female collegiate athletes reported experiencing SUI. During participation in their sport, 40.0% of female collegiate athletes reported experiencing SUI, referred to as sports-related SUI. When reporting SUI experienced during either sport participation or during other exercise-based activities, 58.2% of female collegiate athletes reported SUI.

The proportion of female athletes reporting sports-related SUI varied by sport. The highest prevalence of leakage in sport was reported by gymnasts (80%) and the lowest prevalence was reported by those who participated in rifle (0%). Over half (52.3%) of female athletes who reported sports-related SUI said their symptoms first began in high school. While majority of female collegiate athletes stated they did not avoid their sport because of SUI, one-fifth (20.5%) of athletes with sports-related SUI reported they alter how they move in their sport out of concern for leakage. The impact of sports-related SUI on other aspects of life (family, social, or school life) were reported to be minimal.

Athletes who experience sports-related SUI are most likely to tell either a teammate (49%) or no one (36%). Very few female athletes have told someone in healthcare about this concern: doctor (3%), athletic trainer (4%); physical therapist (1%). Furthermore, only 3% of female collegiate athlete with sports-related SUI reported ever seeking treatment and only 25.8% reported they would find value in seeing a healthcare provider to discuss SUI. Most (76.7%) female collegiate athletes, whether they reported SUI or not, stated they had never been instructed on exercises to strengthen the pelvic floor muscles and 60.6% reported they would find educational programs involving exercises to decrease or prevent SUI beneficial.

In conclusion, SUI does occur in the female collegiate athlete and is often not reported to healthcare providers. Based on this information, the general practice of screening athletes for relevant health conditions during pre-participation physicals may need to include additional questions for SUI. Further investigation needs to explore how to best engage and educate female collegiate athletes on the subject of SUI and how to successfully communicate with and address those with the condition.

Digital Object Identifier (DOI)