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Meta-Analysis
. 2023 Mar;35(3):479-495.
doi: 10.1007/s40520-022-02336-0. Epub 2023 Jan 13.

The impact of urinary incontinence on multiple health outcomes: an umbrella review of meta-analysis of observational studies

Pinar Soysal #  1 , Nicola Veronese #  2 , Simona Ippoliti #  3 , Damiano Pizzol #  4 , Anne Marie Carrie  5 , Simina Stefanescu  5 , Guillermo F López-Sánchez  6 , Yvonne Barnett  7 , Laurie Butler  7 , Ai Koyanagi  8   9 , Louis Jacob  8   10 , Ramy Abou Ghaydya  11   12 , David Sheyn  11   12 , Adonis K Hijaz  11   12 , Jose M Oliva-Lozano  13 , Jose M Muyor  13 , Mike Trott  14 , Andreas Kronbichler  15 , Igor Grabovac  16 , Mark A Tully  17 , Lin Yang  18   19 , Jimin Hwang  20 , Jong Yeob Kim  21 , Seoyeon Park  21 , Junmin Song  22 , Jae Il Shin  23 , Petre-Cristian Ilie #  7 , Lee Smith #  7 ; European Society of Geriatric Medicine Special Interest Group in Systematic Reviews, Meta-Analyses
Affiliations
Meta-Analysis

The impact of urinary incontinence on multiple health outcomes: an umbrella review of meta-analysis of observational studies

Pinar Soysal et al. Aging Clin Exp Res. 2023 Mar.

Abstract

Background and aim: We aimed to capture the breadth of health outcomes that have been associated with the presence of Urinary Incontinence (UI) and systematically assess the quality, strength, and credibility of these associations through an umbrella review and integrated meta-analyses.

Methods: We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p-values, 95% prediction intervals, heterogeneity, small-study effects, and excess significance. We graded the evidence from convincing (Class I) to weak (Class IV).

Results and discussion: From 3172 articles returned in search of the literature, 9 systematic reviews were included with a total of 41 outcomes. Overall, 37 out of the 41 outcomes reported nominally significant summary results (p < 0.05), with 22 associations surviving the application of a more stringent p-value (p < 10-6). UI was associated with worse scores than controls in female sexual function (Class II), while it was also associated with a higher prevalence of depression (odds ratio [OR] = 1.815; 95% confidence interval [CI]: 1.551-2.124), and anxiety (OR = 1.498; 95% CI: 1.273-1.762) (Class IV). UI was associated with poorer quality of life (QoL), higher rate of mortality (hazard ratio = 2.392; 95% CI: 2.053-2.787) an increase in falls, frailty, pressure ulcers, diabetes, arthritis, and fecal incontinence (Class IV).

Conclusions: UI is associated with female sexual dysfunction, with highly suggestive evidence. However, the evidence of other adverse outcomes including depression, anxiety, poorer QoL, higher mortality, falls, pressure ulcers, diabetes, arthritis, fecal incontinence, and frailty is only weak. A multidimensional approach should be taken in managing UI in the clinical setting.

Keywords: Health outcomes; Meta-analysis; Umbrella review; Urinary incontinence.

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References

    1. Abrams P, Cardozo L, Fall M et al (2003) The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the international continence society. Urology 61:37–49. https://doi.org/10.1016/s0090-4295(02)02243-4 - DOI - PubMed
    1. de MacedoDantas TH, Castaneda L, Correia GN et al (2019) Functioning and disability of premenopausal women with urinary incontinence: an assessment by using the world health organization disability assessment schedule-WHODAS 2.0. Neurourol Urodyn. 38:1767–1774. https://doi.org/10.1002/nau.24073 - DOI
    1. Abufaraj M, Xu T, Cao C et al (2021) Prevalence and trends in urinary incontinence among women in the United States 2005–2018. Am J Obstet Gynecol. 225:166.e1-.e12. https://doi.org/10.1016/j.ajog.2021.03.016 - DOI - PubMed
    1. Jacob L, López-Sánchez GF, Oh H et al (2021) Association of multimorbidity with higher levels of urinary incontinence: a cross-sectional study of 23 089 individuals aged ≥15 years residing in Spain. Br J Gen Pract 71:e71–e77. https://doi.org/10.3399/bjgp20X713921 - DOI - PubMed
    1. Nazarko L (2018) Male urinary incontinence management: penile sheaths. Br J Community Nurs 23:110–116. https://doi.org/10.12968/bjcn.2018.23.3.110 - DOI - PubMed

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