Urinary incontinence is defined as "the complaint of any involuntary leakage of 
urine" and is a common problem in the female population with prevalence rates 
varying between 10% and 55% in 15- to 64-year-old women. The most frequent form 
of urinary incontinence in women is stress urinary incontinence, defined as 
"involuntary leakage on effort or exertion, or on sneezing or coughing". The aim 
of this article is to systematically review the literature on urinary 
incontinence and participation in sport and fitness activities with a special 
emphasis on prevalence and treatment in female elite athletes. Stress urinary 
incontinence is a barrier to women's participation in sport and fitness 
activities and, therefore, it may be a threat to women's health, self-esteem and 
well-being. The prevalence during sports among young, nulliparous elite athletes 
varies between 0% (golf) and 80% (trampolinists). The highest prevalence is 
found in sports involving high impact activities such as gymnastics, track and 
field, and some ball games. A 'stiff' and strong pelvic floor positioned at an 
optimal level inside the pelvis may be a crucial factor in counteracting the 
increases in abdominal pressure occurring during high-impact activities. There 
are no randomised controlled trials or reports on the effect of any treatment 
for stress urinary incontinence in female elite athletes. However, strength 
training of the pelvic floor muscles has been shown to be effective in treating 
stress urinary incontinence in parous females in the general population. In 
randomised controlled trials, reported cure rates, defined as <2g of leakage on 
pad tests, varied between 44% and 69%. Pelvic floor muscle training has no 
serious adverse effects and has been recommended as first-line treatment in the 
general population. Use of preventive devices such as vaginal tampons or 
pessaries can prevent leakage during high impact physical activity. The pelvic 
floor muscles need to be much stronger in elite athletes than in other women. 
There is a need for more basic research on pelvic floor muscle function during 
physical activity and the effect of pelvic floor muscle training in female elite 
athletes.