Analysis of Predictive Factors for Return to Sports in Female Athletes With Stress Urinary Incontinence

Nobuo Okui; Tamer Erel; Machiko Aurora Okui

doi:10.7759/cureus.44364

Analysis of Predictive Factors for Return to Sports in Female Athletes With Stress Urinary Incontinence

Cureus. 2023 Aug 30;15(8):e44364. doi: 10.7759/cureus.44364. eCollection 2023 Aug.

Authors

Nobuo Okui¹, Tamer Erel², Machiko Aurora Okui³

Affiliations

¹ Dentistry, Kanagawa Dental University, Yokosuka, JPN.
² Department of Obstetrics and Gynecology, Istanbul University, Cerrahpasa School of Medicine, Istanbul, TUR.
³ Department of Urogynecology, Yokosuka Urogynecology Clinic, Yokosuka, JPN.

Abstract

Introduction This study aimed to identify predictive factors for successful return to sports among elite female athletes (EFAs) experiencing stress urinary incontinence (SUI). We used machine learning to analyze these predictors. Methods This study was conducted at Yokosuka Urogynecology and Urology Clinic, located in Yokosuka City, Kanagawa, Japan. A total of 153 EFAs with postpartum SUI were included in this retrospective cohort study. Information regarding the frequency of pelvic floor muscle training (PFMT), treatment approaches, rates of return to sports after one year, and one-hour pad test (1HrPadtest) at three months were collected. Results At three months, 26.8% of the EFAs improved in SUI; after one year, 28.1% returned to their respective sports successfully. The equation for predicting return to sports (logit(p)) involved several factors: (a) serum total testosterone, (b) PFMT frequency per week, (c) 1HrPadtest at three months, and (d) vaginal erbium-doped yttrium aluminum garnet laser (VEL) + urethral EL (UEL) treatment. The equation was as follows: -126 - 0.07276a + 25.98b - 1.947c - 25.32d, with a logit(p) cutoff point at 0.5. The optimal cutoff values and the four influential factors were determined through a receiver operating characteristic (ROC) analysis and the random forest model, respectively. Conclusions For EFAs with severe SUI to successfully return to their sports activities, the PFMT frequency was paramount. Patients who exhibited unsatisfactory results in the 1HrPadtest at the three-month mark benefited from the VEL+UEL treatment. Serum total testosterone proved to be an effective discerning criterion.

Keywords: ai and robotics in healthcare; chatgpt; elite female athletes; pelvic floor muscle training; serum total testosterone; stress urinary incontinence; urethral erbium laser for urinary incontinence; vaginal erbium laser for urinary incontinance.