Grant: Project Grant - Priority Announcement: Female Athlete Health

Approximately one third of female athletes experience urine leakage during their sport training. This leakage is embarrassing, impairs performance, and leads to a reduction in or withdrawal from athletic activities. Vaginal pessaries are devices that are inserted into the vagina to support the pelvic organs. Pessaries can require fitting by a health care provider, or can be purchased off-the-shelf and self-fitted, the latter eliminating the need for specialist consultation or private provider services. However, the effectiveness of vaginal pessaries to mitigate urine leakage during athletic training has not been evaluated in a high quality study. The aim of this randomized, controlled trial is to evaluate the effectiveness of an off-the-shelf pessary worn during training/competition to reduce or eliminate urine leakage among athletes who compete in field sports, court sports and CrossFit. Sixty adult, female athletes will be recruited from each sport type (field, court, CrossFit) based on self-reporting regular leakage of urine during training/competition. Each participant will receive a vaginal pessary (Uresta®), and will use it for four weeks either before or after being monitored for four weeks while they use no intervention. Participants will report on their leakage symptoms, satisfaction with the pessary, and sport performance after using the pessary and after using no intervention for four weeks. Participants will also be monitored for any adverse events. We expect that the pessary intervention will be effective for reducing urine leakage and that athletes will be satisfied with it. We also expect that sport performance will improve when symptoms of urine leakage are reduced. Ultimately we expect this study to provide strong evidence for recommending an off-the-shelf pessary to athletes who experience urine leakage.