Hypothesis / aims of study
Sport climbing has seen a significant rise in popularity over the last two decades [1]. Sport climbing requires high levels of flexibility, core strength, static and dynamic postural control and coordination, management of intra-abdominal pressure, fatigue resistance and psychological engagement. These factors are known to potentially be associated with urinary incontinence (UI).
The primary aim of this study was to assess the prevalence, type and severity of urinary incontinence in adult female sport climbers. Secondary aims were to determine the prevalence of climbing-induced UI and to identify factors associated with UI in this population.
Study design, materials and methods
A cross-sectional observational study was conducted using an online self-administered questionnaire . Adult female sport climbers were recruited via climbing clubs, federations and social media platforms. The questionnaire was adapted to the context of climbing practice and included the International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF). Descriptive statistics were calculated. Associations were explored using odds ratios (OR) with p-values and Cramer’s V, with a significance level set at p<0.05.
Results
A total of 482 completed questionnaires were analysed. Median age and body weight were 35 years and 57.5 kg. 60.4% of participants were nulliparous. Among parous women, 87.1% reported at least one vaginal delivery. In addition to climbing, 32.9% reported practising running or jogging.
Overall UI prevalence was 38.8% (n=187). Stress urinary incontinence (SUI) was the most common type. 39.0% reported cough-induced UI and 24.3% sports-induced UI. Urgency urinary incontinence prevalence was 18.3%. Severe or very severe UI was reported by 2.5%. Age and weight were not linked to an increase in the IU (OR=0.98[IC 95%:0.93-1.03], p=0.362 and OR=1.00[IC 95%:0.96-1.05]; p=0.0217 respectively).
Sport climbing-induced UI prevalence was 17.4% (n=84). In this subgroup, cough-induced UI was reported by 67.9% and UI during other sports by 83.3%. Leakage frequency was less than two to several times per week in 69% of cases, and 83.3% reported small volumes of leakage. The impact on daily life was rated as zero to low (ICIQ impact score 0–3) by 61.9%, while 38.1% reported moderate to severe impact (score ≥4). Pre-voiding before climbing sessions and wearing protective pads were the most frequently reported coping strategies (42.9%). Two participants reported using a pessary whilst playing sport.
Comparison between climbers without UI and those with climbing-induced UI showed no significant differences in age or weight. Parity tended to be higher in the UI group, but the difference was not statistically significant (p=0.201). Vaginal delivery was significantly associated with UI (OR=1.67, p=0.046). Women with climbing-induced UI had eight time more chance of experiencing UI during other sporting activities (OR=8.29, p<0.00001, V≈0.478), and four time more chance of experiencing cough-induced UI (OR=4.30, p<0.00001, V≈0.26).
Interpretation of results
This study shows that climbing-induced UI affects fewer than one in five participants, didn’t increase with age, and is generally characterised by low leakage volume, low frequency and limited impact on daily life. These findings suggest that sport climbing does not expose women to a higher risk of UI compared with the general female population or with athletes of similar age practising other sports [2, 3]. The association observed with vaginal delivery and the strong association between climbing-induced UI and cough-induced UI or other sports-induced UI suggests that leakage occurring during climbing may reflect an underlying continence vulnerability rather than a climbing-specific mechanism.