Urinary Incontinence and Quality of Life: a Systematic Review and Meta-analysis

Overview

Journal Aging Clin Exp Res

Publisher Springer

Specialty Geriatrics

Date 2020 Sep 23

PMID 32964401

Citations 69

Authors

Damiano Pizzol

Jacopo Demurtas

Stefano Celotto

Stefania Maggi

Lee Smith

Gabriele Angiolelli

Mike Trott

Lin Yang

Nicola Veronese

Affiliations

Soon will be listed here.

Abstract

Background: Urinary incontinence (UI) and low quality of life (QoL) are two common conditions. Some recent literature proposed that these two entities can be associated. However, no attempt was made to collate this literature. Therefore, the aim of this study was to conduct a systematic review and meta-analysis of existing data to estimate the strength of the association between UI and QoL.

Methods: An electronic search of major databases up to 18th April 2020 was carried out. Meta-analysis of cross-sectional and case-control studies comparing mean values in QoL between patients with UI and controls was performed, reporting random-effects standardized mean differences (SMDs) ± 95% confidence intervals (CIs) as the effect size. Heterogeneity was assessed with the I.

Results: Out of 8279 articles initially screened, 23 were finally included for a total of 24,983 participants, mainly women. The mean age was ≥ 50 years in 12/23 studies. UI was significantly associated with poor QoL as assessed by the short-form 36 (SF-36) total score (n = 6 studies; UI: 473 vs. 2971 controls; SMD = - 0.89; 95% CI - 1.3 to - 0.42; I = 93.5) and by the sub-scales of SF-36 and 5/8 of the domains included in the SF-36. Similar results were found using other QoL tools. The risk of bias of the studies included was generally high.

Conclusions: UI is associated with a poor QoL, with a strong level of certainty. This work, however, mainly based on cross-sectional and case-control studies, highlights the necessity of future longitudinal studies for better understanding the importance of UI on QoL.

Citing Articles

Pelvic floor muscle training with feedback or biofeedback for urinary incontinence in women.

Fernandes A, Jorge C, Weatherall M, Ribeiro I, Wallace S, Hay-Smith E Cochrane Database Syst Rev. 2025; 3:CD009252.

PMID: 40066950 PMC: 11895424. DOI: 10.1002/14651858.CD009252.pub2.

Incremental predictive value of intrinsic capacity and environmental characteristics in the risk prediction of incident disability.

Yu R, Leung G, Lai D, Tam L, Cheng C, Kong S JAR Life. 2025; 14:100004.

PMID: 40046642 PMC: 11863695. DOI: 10.1016/j.jarlif.2025.100004.

The prevalence of incontinence and its impact on quality of life.

Guler Sonmez T, Ugras E, Gul Sahin E, Fidanci I, Aksoy H, Ayhan Baser D Medicine (Baltimore). 2025; 103(52):e41108.

PMID: 39969293 PMC: 11688079. DOI: 10.1097/MD.0000000000041108.

Determinants of Quality of Life in Patients With Urinary Incontinence: An Assessment Using the Incontinence Quality of Life (I-QOL) Scale.

Mahfoudi H, El Harch I, Maiouak M, Benmaamar S, Bourkhime H, Omari M Cureus. 2025; 16(12):e76673.

PMID: 39886716 PMC: 11781331. DOI: 10.7759/cureus.76673.

Potential profiling of social alienation in older female patients with stress urinary incontinence.

Li Y, Wang H Front Public Health. 2025; 12:1496539.

PMID: 39882118 PMC: 11776299. DOI: 10.3389/fpubh.2024.1496539.

References

Farage M, Miller K, Berardesca E, Maibach H . Psychosocial and societal burden of incontinence in the aged population: a review. Arch Gynecol Obstet. 2007; 277(4):285-90. DOI: 10.1007/s00404-007-0505-3. View

Ebbesen M, Hunskaar S, Rortveit G, Hannestad Y . Prevalence, incidence and remission of urinary incontinence in women: longitudinal data from the Norwegian HUNT study (EPINCONT). BMC Urol. 2013; 13:27. PMC: 3674916. DOI: 10.1186/1471-2490-13-27. View

Oh S, Ku J . Impact of stress urinary incontinence and overactive bladder on micturition patterns and health-related quality of life. Int Urogynecol J Pelvic Floor Dysfunct. 2006; 18(1):65-71. DOI: 10.1007/s00192-006-0112-z. View

Moore K, Jensen L . Testing of the Incontinence Impact Questionnaire (IIQ-7) with men after radical prostatectomy. J Wound Ostomy Continence Nurs. 2000; 27(6):304-12. DOI: 10.1067/mjw.2000.110623. View

Hawkins K, Pernarelli J, Ozminkowski R, Bai M, Gaston S, Hommer C . The prevalence of urinary incontinence and its burden on the quality of life among older adults with medicare supplement insurance. Qual Life Res. 2010; 20(5):723-32. DOI: 10.1007/s11136-010-9808-0. View

Lim R, Liong M, Leong W, Khan N, Yuen K . Effect of Stress Urinary Incontinence on the Sexual Function of Couples and the Quality of Life of Patients. J Urol. 2016; 196(1):153-8. DOI: 10.1016/j.juro.2016.01.090. View

Dooley Y, Kenton K, Cao G, Luke A, Durazo-Arvizu R, Kramer H . Urinary incontinence prevalence: results from the National Health and Nutrition Examination Survey. J Urol. 2007; 179(2):656-61. DOI: 10.1016/j.juro.2007.09.081. View

Katz S, Downs T, CASH H, Grotz R . Progress in development of the index of ADL. Gerontologist. 1970; 10(1):20-30. DOI: 10.1093/geront/10.1_part_1.20. View

Rannestad T, Skjeldestad F . Ferrans and Powers' Quality of life index applied in urinary incontinence research--a pilot study. Scand J Caring Sci. 2010; 25(2):410-6. DOI: 10.1111/j.1471-6712.2010.00852.x. View

10.

Veronese N, Soysal P, Stubbs B, Marengoni A, Demurtas J, Maggi S . Association between urinary incontinence and frailty: a systematic review and meta-analysis. Eur Geriatr Med. 2021; 9(5):571-578. DOI: 10.1007/s41999-018-0102-y. View

11.

Borello-France D, Zyczynski H, Downey P, Rause C, Wister J . Effect of pelvic-floor muscle exercise position on continence and quality-of-life outcomes in women with stress urinary incontinence. Phys Ther. 2006; 86(7):974-86. View

12.

Norton P, Brubaker L . Urinary incontinence in women. Lancet. 2006; 367(9504):57-67. DOI: 10.1016/S0140-6736(06)67925-7. View

13.

Martinez Agullo E, Ruiz Cerda J, Gomez Perez L, Rebollo P, Perez M, Chaves J . [Impact of urinary incontinence and overactive bladder syndrome on health-related quality of life of working middle-aged patients and institutionalized elderly patients]. Actas Urol Esp. 2010; 34(3):242-50. View

14.

Choi E, Lam C, Chin W . The health-related quality of life of Chinese patients with lower urinary tract symptoms in primary care. Qual Life Res. 2014; 23(10):2723-33. DOI: 10.1007/s11136-014-0725-5. View

15.

Bogner H, Gallo J, Swartz K, Ford D . Anxiety disorders and disability secondary to urinary incontinence among adults over age 50. Int J Psychiatry Med. 2002; 32(2):141-54. PMC: 2826159. DOI: 10.2190/Y0L8-K2UV-BG4N-VW2J. View

16.

Tozun M, Ayranci U, Unsal A . Prevalence of urinary incontinence among women and its impact on quality of life in a semirural area of Western Turkey. Gynecol Obstet Invest. 2009; 67(4):241-9. DOI: 10.1159/000209310. View

17.

Aguilar-Navarro S, Navarrete-Reyes A, Grados-Chavarria B, Garcia-Lara J, Amieva H, Avila-Funes J . The severity of urinary incontinence decreases health-related quality of life among community-dwelling elderly. J Gerontol A Biol Sci Med Sci. 2012; 67(11):1266-71. DOI: 10.1093/gerona/gls152. View

18.

Jenkinson C, Coulter A, Wright L . Short form 36 (SF36) health survey questionnaire: normative data for adults of working age. BMJ. 1993; 306(6890):1437-40. PMC: 1677870. DOI: 10.1136/bmj.306.6890.1437. View

19.

Coyne K, Sexton C, Irwin D, Kopp Z, Kelleher C, Milsom I . The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study. BJU Int. 2008; 101(11):1388-95. DOI: 10.1111/j.1464-410X.2008.07601.x. View

20.

Liberati A, Altman D, Tetzlaff J, Mulrow C, Gotzsche P, Ioannidis J . The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009; 6(7):e1000100. PMC: 2707010. DOI: 10.1371/journal.pmed.1000100. View