Table 2. Detailed description of the included studies.

UI: urinary incontinence, AI: anal incontinence, POP: pelvic organ prolapse, SUI: stress urinary incontinence, MUI: mixed urinary incontinence, UUI: urge urinary incontinence, PFMT: pelvic floor muscle training, G1: group 1, G2: group 2, G3: group 3, ICIQ-UI SF: International Consultation on Incontinence Questionnaire-Short Form, FSD: female sexual dysfunction, FSFI: The Female Sexual Function Index, FA: female athletes.

S no.	Author and year	Purpose	Methodology	Results	Quality assessment
1.	Almousa et al. (2019) [17]	To investigate the prevalence of UI in nulliparous female athletes by systematically reviewing the studies.	Databases consisting of Embase, Medline, Cochrane Library, and Cinahl were searched for literature review and the quality was assessed of the included studies. The data was extracted in a standardized data extraction spreadsheet.	The systematic review contained 23 studies. The range of the UI prevalence observed during sports activities was 5.7% to 80%. Depending on the sport, UI prevalence varies. UI was found to be most prevalent among trampoline athletes. The data indicate that female athletes, particularly those who participate in high-impact sports, frequently experience UI.	High
2.	Dos Santos et al. (2018) [18]	To determine the UI prevalence and FSD and analyze the risk factors in nulliparous athletes.	A cross-sectional study involving 50 nulliparous athletes was carried out. Athletes who competed at the municipal or state level and were at least eighteen years old, sexually active, in the reproductive phase and nulliparous were included. The team coaches conducted the athlete recruitment through phone or email. The athletes were given three questionnaires: demographic; ICIQ-UI-SF for UI; and FSFI, which assessed sexual function in six domains: sexual arousal, sexual desire, orgasm, vaginal lubrication, pain, and sexual satisfaction.	A 48% prevalence of UI was observed, of which 50% showed UUI, 37.5% showed SUI, and 12.5% showed MUI. FSD was present in 44% of cases. Twenty-four percent of athletes had both UI and FSD concurrently. Hours of training were revealed to be a risk factor for UI. Hence, the most susceptible to UI are nulliparous athletes who engage in high-impact modalities.	High
3.	Khan (2019) [4]	To investigate the frequency of urinary incontinence among female athletes	Non-probability purposive sampling technique was used. The duration of the study was from September 2017 to February 2018. Participants were enrolled in various sports academies. A self-administered questionnaire was the mode of investigation. The questionnaire included close-ended questions in three parts. Part A included demographics and menstrual history, suggestive past medical history; part B included questions related to sports activities, involving the time duration of physical activity, drug intake, and addictions; and part C included questions related to urinary incontinence that if the athlete was found to have urinary incontinence, would she consider it as a problem, what are the preventive measures she may have been taking, and whether she thinks that physical therapy would be a better option for treatment.	A total of 373 female athletes were included in the study. UI was experienced at least once by 242 (64.9%) athletes, while 131 (35.1%) had not experienced it. Out of this percentage, 12.1% had SUI, 36.7% had UUI, and 16.1% had MUI.	High
4.	Mahoney et al. (2023) [19]	To evaluate the frequency, acceptance, preferred information sources, and treatment rates in female athletes associated with SUI.	A novel cross-sectional survey was distributed online through social media groups among female strength athletes and responses were received from 425 women in less than four days.	50.2% reported experiencing incontinence during competition, 59.1% of athletes reported experiencing incontinence with regular strength training, and 43.5% reported experiencing incontinence with daily activities. Just 9.4% of the athletes who had incontinence had ever sought treatment, and 61.4% never had the condition prior to beginning their sports activity. According to 67.9% of all athletes surveyed, incontinence is a common occurrence in their sport. Hence, the findings indicate that female strength athletes frequently have SUI, which could be a result of the activity itself. Normalization of SUI is typical, and only a few athletes pursue treatment.	High
5.	Pires et al. (2020) [20]	To identify which modality is most likely to emphasize SUI and to organize the data that assessed the UI prevalence in female athletes.	Utilizing the EMBASE, PubMed, Web of Science, and Scopus databases, a comprehensive literature search of recent interventional trials of SUI over the previous ten years was conducted from September to December 2018. The Downs and Black scale were utilized to evaluate the methodological quality, and meta-analysis was employed to analyze the data gathered from various research.	Nine studies were included based on the eligibility criteria highlighting UI in various sports. The UI prevalence was 25.9% in female athletes in different sports, of which SUI involved 20.7%. The high-impact sport that was found to be the most prevalent was Volleyball (75.6%).	High
6.	Kelecic et al. (2023) [21]	To evaluate the frequency, risk factors, and severity in Croatian female athletes for UI.	Individual female athletes received an anonymous survey through online mode consisting of an ICIQ-UI SF questionnaire and general characteristics of sports in May 2022.	Among the 70 female athletes who competed in 12 different sports, the percentage of athletes with UI was 24.3%. This included 3 (42.9%) tennis players, 8 (29.6%) handball players, 2 (40%) water polo players, 1 (14.3%) synchronized swimmer, 7 (14.3%) soccer players, 1 (50%) weightlifter and the only (100%) swimmer. According to the ICIQ-UI SF, 70.59% of FA with UI reported having minor urine leaks once a week or less, mostly after clothing and urinating (35.29%). While the UI intensity ranges from minimal (47%) to moderate (53%), its interference with quality of life is mild (70.59%) and moderately severe (29.41%).	High
7.	Pires et al. (2020) [22]	To determine the impact of pelvic floor muscle training and its effectiveness in elite female volleyball athletes for SUI.	Fourteen athletes in the age range between 18 and 30, both continent and incontinent, were randomized to either the experimental or control groups. For four months, the experimental group followed a regimen to strengthen their pelvic floor muscles. There were three stages to this: power, strength training, and awareness/stabilization. During the same period, there was no intervention planned for the control group. For both groups, measurements were taken at the beginning and end of the study. A perineometer was used to measure maximum voluntary contractions, a Pad test was used to measure involuntary loss of urine, and the King's Health Questionnaire was used to assess quality of life.	The baseline anthropometric and sociodemographic features did not differ significantly. When the two groups were compared, the experimental group showed significant differences in the variation between the initial and final phases. It also reduced urine loss (p = 0.025) and improved maximum voluntary pelvic contractions (p < 0.001). The experimental group's percentage of urine loss dropped from 71.4 to 42.9%, indicating that athletes with SUI may benefit from the 16-week protocol intervention.	High
8.	Sorrigueta-Hernández et al. (2020) [23]	The objective of this study is to determine the scientific basis for pelvic floor dysfunctions that are linked to UI in female professional athletes and to assess if pelvic floor physiotherapy (PT) can effectively address UI in these athletes.	The study consisted of a meta-analysis in which the articles were analyzed using the keywords "pelvic floor dysfunction elite female athletes," "urinary incontinence elite female athletes," "pelvic floor dysfunction elite female athletes physiotherapy," and "urinary incontinence elite female athletes physiotherapy." The measures studied consisted of study design, sample size, age range, type of sport, prevalence of UI type diagnosed in athletes, etiopathogenesis, response to the PT and general treatment, and associated diseases or health conditions. Based on the impact of each sport on the pelvic floor the groups were divided into the following categories. G1: low-impact (swimming, throwing athletics, golf, running athletics, non-competitive sports); G2: moderate impact (field hockey, badminton, baseball, tennis, cross-country skiing); and G3: high impact (artistic gymnastics, aerobics, soccer, rhythmic gymnastics, ballet, gymnastics, judo, jump sports (high, long, triple and pole jump)), volleyball, basketball, handball).	The average number of athletes per study was 284.38±373.867, the mean age was 22.69±2.70. Case-control studies accounted for 39.60% of all study types, with cross-sectionals accounting for 30.20%. The study found that the most common types of UI were most often unspecified (47.20%), SUI (24.50%), or general UI (18.90%). 54.70% of studies were based on prevalence, followed by etiopathogenesis consisting of 28.30% and 17.00% on treatment.	Moderate
9.	Garrington et al. (2022) [15]	To assess the effectiveness and safety in elite female athletes and military personnel of specific prevention and management approaches for UI, AI, and POP.	Databases were searched using keywords like "female," "military," "athlete," and "pelvic floor dysfunction," related to the management and prevention of AI, UI, and POP. Two reviewers selected and evaluated the studies independently. After data extraction, a critical narrative synthesis method was performed.	A total of eight studies were included based on the criteria. One study was based on AI and seven on UI were conducted. Research on female athletes and military women who experienced UI symptoms frequently found that PFMT was a common and helpful treatment. Female athletes benefited from education. Concerningly, the self-management techniques involved the use of pads and fluid restriction.	High