The Posterior Urethrovesical Angle in Continent and Incontinent Women Before and After a Treadmill Run

The posterior urethrovesical angle (PUVA) is larger in women with general stress urinary incontinence (SUI) than those without. We aimed to determine whether baseline PUVA or changes in PUVA after a treadmill run differ between runners with and without running-induced SUI (RI-SUI). Among runners with RI-SUI, we also compared those who leaked urine during a treadmill protocol and those who did not.

We recruited female runners with and without RI-SUI. Ultrasound imaging was used to measure bladder volume (BV) in supine (transabdominal) and PUVA in standing (transperineal), before and after a standardized treadmill run. Separate general linear models (α = 0.05) included PUVA as the dependent variable, time (pre- vs post-run) and group (continent vs incontinent) as independent variables, and baseline BV and PUVA, age and parity as covariates, first comparing runners with and without RI-SUI then, among runners with RI-SUI, comparing those who leaked urine and those who did not.

Of the 96 participating runners, data from 85 (28 with RI-SUI, 57 without) were analyzed after excluding images with poor PUVA visualization. PUVA increased after running (continent 120.4 ± 15.8º to 125.6 ± 15.7º; RI-SUI 123.8 ± 15.6º to 127.0 ± 17.1º) with no significant between-group differences or interactions (time × group F(1,1) = 1.32, p = 0.25, partial η² = 0.016). There was no difference in PUVA or change in PUVA between those with RI-SUI who did and did not leak urine during the run.

Although proximal urethral support is reduced in women after a treadmill run, the PUVA does not appear to be independently associated with RI-SUI.