Key Points

Urinary incontinence affects approximately four in ten adult women athletes, but prevalence estimates vary widely between cohorts.
Common sport labels showed limited ability to explain between-cohort variability in urinary incontinence prevalence in meta-regression, likely reflecting exposure misclassification and unmeasured pelvic floor-specific loading.
Sport type-based risk stratification may fail to capture clinically relevant exposure patterns and could delay identification of athletes at risk of urinary incontinence.
Weekly training volume showed the most consistent association with urinary incontinence odds, but should not be interpreted as a mechanistic proxy for pelvic floor loading and instead represents an exposure-based hypothesis-generating indicator.
Clinically, these findings support exposure-aware screening and early care pathways across sports and future research integrating training exposure, pelvic floor-specific measures and symptom response to characterise a multi-dimensional pelvic floor “dose”.