Do Intravaginal Devices Reduce Urinary Incontinence in Female Runners?

NCT ID: NCT05773378

Last Updated: 2024-12-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-04-14

Study Completion Date

2025-09-01

Brief Summary

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More than one in five females experience the embarrassment and shame of urine leakage while exercising and this urinary incontinence (UI) is a substantial barrier to exercise. As many as one in three females with UI report that they limit their physical activity due to incontinence: 11.6% by not exercising at all, 11.3% by exercising less and 12.4% by changing the type of exercise they perform. It is imperative to look for alternatives to manage this condition, as it is a key reason why females abandon the very physical exercise that is necessary to maintain or improve their physical and mental health and their quality of life.

While there is Grade A evidence for pelvic floor muscle training and some evidence for intravaginal pessaries to reduce symptoms of UI in general female populations, no study has evaluated the impact of conservative interventions specifically on UI experienced predominantly during running.

Detailed Description

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Urinary incontinence (UI) is a serious public health concern, imposing a significant financial burden. In Canada the direct and indirect health costs associated with UI total over 3.6 billion annually and no estimates of disease burden take into account deconditioning that results from withdrawal from physical activity nor effects on mental health or quality of life. Although the primary risk factor for UI is pregnancy and vaginal delivery, it was recently reported that between 20% and 40% of nulliparous females report urine leakage when they engage in physical activity.

Urinary continence is maintained as long as urethral closure pressure remains higher than bladder pressure. This is accomplished through a complex combination of mechanisms, including smooth and striated urethral sphincter muscle action, urethral venous engorgement and mucous secretions within the urethra, and the proper transfer of loads to the urethra, which depends on adequate bladder neck and urethral connective tissue support as well as pelvic floor muscle (PFM) action. The associations among physical activity, pelvic floor morphology and function, and UI are not clear. A recent systematic review retrieved 18 mainly small studies investigating the association between physical activity and pelvic floor dysfunction. Exercise at mild to moderate intensity appears to be protective, decreasing both the odds and the risk of experiencing urinary incontinence. However, females who engage in high-impact activities such as running are more likely to report UI during exercise than those who engage in mild or moderate intensity exercise, thus chronic and repetitive loading of the pelvic floor may have negative consequences.

While there is Grade A evidence for pelvic floor muscle training and some evidence for intravaginal pessaries to reduce symptoms of UI in general female populations, no study has investigated about interventions specific to running-induced UI.

Conditions

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Urinary Incontinence

Keywords

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exercise-induced urinary incontinence running-induced urinary incontinence intravaginal pessary tampon pelvic floor

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Pessary Intervention

Participants randomized to this group will receive an Uresta Incontinence Pessary to use each time they run over a 10-week period. They will be instructed to use the pessary only while running and remove it and wash it with soap and water when the training is over.

Uresta is a reusable and removable device made of hypoallergenic medical-grade resin that is inserted into the vagina to provide mechanical support. It comes with a starter kit with 3 different sizes which work for over 80% of women. Participants will be instructed on how to test the 3 sizes to find out which one is right for them.

Group Type EXPERIMENTAL

Pessary Intervention

Intervention Type DEVICE

Participants will receive a 3-size fitting kit and will fit the appropriate size based on manufacturer instruction. Once the size is verified, the participants will be asked to use the pessary while running over a 10-week period.

Tampon Intervention

Participants randomized to this group will receive 60 regular Tampax tampons and will be instructed to use them each time they run over a 10-week period. The tampon should be used only while running and removed and discarded when the training is over. Four weeks after the intervention (at the 16 weeks follow-up), they will receive a pessary with instruction how to use it if they desire so.

Group Type EXPERIMENTAL

Tampon Intervention

Intervention Type DEVICE

Participants will receive 60 regular Tampax tampons and will be instructed to use them each time they run over a 10-week period.

Control Group

Participants randomized to this group won't receive any intervention and will be asked to continue their running training as usual for 10-weeks. They will also be instructed to not begin any treatment for urinary incontinence until their reassessment. Four weeks after the intervention (at the 16 weeks follow-up), they will receive a pessary with instruction how to use it if they desire so.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Pessary Intervention

Participants will receive a 3-size fitting kit and will fit the appropriate size based on manufacturer instruction. Once the size is verified, the participants will be asked to use the pessary while running over a 10-week period.

Intervention Type DEVICE

Tampon Intervention

Participants will receive 60 regular Tampax tampons and will be instructed to use them each time they run over a 10-week period.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Females aged 18 years and over who run at least twice a week for a minimum of 10K/week (minimum speed of 6 km/h to ensure high impact), who have done so for at least 6 months (to ensure adequate duration of exposure), and who commit to continue the same amount during the study period
* Who regularly (≥ 1 per week) experience urine leakage while running.

Exclusion Criteria

* Any risk factors related to exercise;
* Pain or musculoskeletal injury at the time of the screening;
* History of urogenital surgery;
* Symptoms of the female athlete triad;
* Have a known neurologic disorder (e.g. stroke, multiple sclerosis);
* Pregnancy or partum within the previous year;

For the in-lab assessment:

* Ability to run with a moderately full bladder for 38 minutes on a treadmill
* BMI ≥ 30
* Pelvic organ prolapse ≥ 2
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University of Ottawa

OTHER

Sponsor Role lead

Responsible Party

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Dr. Linda McLean

Professor in the School of Rehabilitation Sciences at University of Ottawa

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Linda McLean

Role: PRINCIPAL_INVESTIGATOR

University of Ottawa

Locations

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McLean Function Measurement Lab

Ottawa, Ontario, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Linda McLean

Role: CONTACT

Phone: 613-562-5800

Email: [email protected]

Sabine Vesting

Role: CONTACT

Phone: 613-562-5800

Email: [email protected]

Facility Contacts

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Anne-Marie MacDonald, MSc

Role: primary

Linda McLean, PhD

Role: backup

Linda McLean, PhD

Role: backup

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Other Identifiers

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H-06-22-8219

Identifier Type: -

Identifier Source: org_study_id