Skip to main content

Advertisement

Log in

Prevention of Urinary Incontinence in Women

  • Female Urology (L Cox, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Despite available treatments for urinary incontinence, the data regarding prevention is less established. This review sought to identify prevention measures and discuss their underlying evidence base with an attempt to include the most recent updates in the field.

Recent Findings

Urinary incontinence is a prevalent issue among women, particularly surrounding pregnancy and menopause. Interventions regarding pregnancy include not only general health promotion but also potentially interventions such as pelvic floor muscle training and decisions regarding method of delivery. With regard to menopause, the literature suggests avoiding treatments that have adverse effects on continence. Lastly, promoting healthy life style and reducing effects of co-morbid conditions can impact a woman’s continence.

Summary

The literature indicates that preventative strategies exist for urinary incontinence, though the data is limited in this area. Further work is needed to determine the impact of prevention measures and how best to implement them.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Herschorn S, Gajewski J, Schulz J, Corcos J. A population-based study of urinary symptoms and incontinence: the Canadian urinary bladder survey. BJU Int. 2008;101(1):52–8.

    PubMed  Google Scholar 

  2. Onur R, Deveci SE, Rahman S, Sevindik F, Acik Y. Prevalence and risk factors of female urinary incontinence in eastern Turkey. Int J Urol. 2009;16(6):566–9.

    PubMed  Google Scholar 

  3. Zhu L, Lang J, Liu C, Han S, Huang J, Li X. The epidemiological study of women with urinary incontinence and risk factors for stress urinary incontinence in China. Menopause. 2009;16(4):831–6.

    PubMed  Google Scholar 

  4. Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S, Norwegian ES. Urinary incontinence after vaginal delivery or cesarean section. N Engl J Med. 2003;348(10):900–7.

    PubMed  Google Scholar 

  5. Kobashi KC, Albo ME, Dmochowski RR, Ginsberg DA, Goldman HB, Gomelsky A, et al. Surgical treatment of female stress urinary incontinence (SUI): AUA/SUFU Guideline (2017): American Urological Association; 2017 [cited 2020 01/20/2020]. Available from: https://www.auanet.org/guidelines/stress-urinary-incontinence-(sui)-guideline.

  6. Wesnes SL, Lose G. Preventing urinary incontinence during pregnancy and postpartum: a review. Int Urogynecol J. 2013;24(6):889–99.

    PubMed  Google Scholar 

  7. Wesnes SL, Rortveit G, Bo K, Hunskaar S. Urinary incontinence during pregnancy. Obstet Gynecol. 2007;109(4):922–8.

    PubMed  Google Scholar 

  8. Waetjen LE, Ye J, Feng WY, Johnson WO, Greendale GA, Sampselle CM, et al. Association between menopausal transition stages and developing urinary incontinence. Obstet Gynecol. 2009;114(5):989–98.

    PubMed  PubMed Central  Google Scholar 

  9. Hijaz A, Sadeghi Z, Byrne L, Hou JC, Daneshgari F. Advanced maternal age as a risk factor for stress urinary incontinence: a review of the literature. Int Urogynecol J. 2012;23(4):395–401.

    PubMed  Google Scholar 

  10. •• Aune D, Mahamat-Saleh Y, Norat T, Riboli E. Body mass index, abdominal fatness, weight gain and the risk of urinary incontinence: a systematic review and dose-response meta-analysis of prospective studies. BJOG. 2019;126(12):1424–33 Recent meta-analysis of the most recent prospective studies showing the dose-effect of body weight on risk of urinary incontinence.

    CAS  PubMed  Google Scholar 

  11. Viktrup L, Rortveit G, Lose G. Risk of stress urinary incontinence twelve years after the first pregnancy and delivery. Obstet Gynecol. 2006;108(2):248–54.

    PubMed  Google Scholar 

  12. Wesnes SL, Hunskaar S, Bo K, Rortveit G. Urinary incontinence and weight change during pregnancy and postpartum: a cohort study. Am J Epidemiol. 2010;172(9):1034–44.

    PubMed  PubMed Central  Google Scholar 

  13. •• Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018;10:CD005654 Cochrane review showing higher rates of cure associated with PFMT.

    PubMed  Google Scholar 

  14. Sangsawang B, Sangsawang N. Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment. Int Urogynecol J. 2013;24(6):901–12.

    PubMed  PubMed Central  Google Scholar 

  15. Hilde G, Staer-Jensen J, Ellstrom Engh M, Braekken IH, Bo K. Continence and pelvic floor status in nulliparous women at midterm pregnancy. Int Urogynecol J. 2012;23(9):1257–63.

    PubMed  Google Scholar 

  16. •• Woodley SJ, Boyle R, Cody JD, Morkved S, Hay-Smith EJC. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2017;12:CD007471 Cochrane review showing benefit of antenatal PFMT on short-term urinary continence post-partum.

    PubMed  Google Scholar 

  17. Fritel X, de Tayrac R, Bader G, Savary D, Gueye A, Deffieux X, et al. Preventing urinary incontinence with supervised prenatal pelvic floor exercises: a randomized controlled trial. Obstet Gynecol. 2015;126(2):370–7.

    PubMed  Google Scholar 

  18. Reilly ET, Freeman RM, Waterfield MR, Waterfield AE, Steggles P, Pedlar F. Prevention of postpartum stress incontinence in primigravidae with increased bladder neck mobility: a randomised controlled trial of antenatal pelvic floor exercises. BJOG. 2014;121(Suppl 7):58–66.

    PubMed  Google Scholar 

  19. Stothers L, Friedman B. Risk factors for the development of stress urinary incontinence in women. Curr Urol Rep. 2011;12(5):363–9.

    PubMed  Google Scholar 

  20. de Mattos Lourenco TR, Matsuoka PK, Baracat EC, Haddad JM. Urinary incontinence in female athletes: a systematic review. Int Urogynecol J. 2018;29(12):1757–63.

    PubMed  Google Scholar 

  21. Matthews CA, Whitehead WE, Townsend MK, Grodstein F. Risk factors for urinary, fecal, or dual incontinence in the nurses' health study. Obstet Gynecol. 2013;122(3):539–45.

    PubMed  PubMed Central  Google Scholar 

  22. Eftekhar T, Hajibaratali B, Ramezanzadeh F, Shariat M. Postpartum evaluation of stress urinary incontinence among primiparas. Int J Gynaecol Obstet. 2006;94(2):114–8.

    CAS  PubMed  Google Scholar 

  23. Groutz A, Rimon E, Peled S, Gold R, Pauzner D, Lessing JB, et al. Cesarean section: does it really prevent the development of postpartum stress urinary incontinence? A prospective study of 363 women one year after their first delivery. Neurourol Urodyn. 2004;23(1):2–6.

    PubMed  Google Scholar 

  24. Serati M, Salvatore S, Khullar V, Uccella S, Bertelli E, Ghezzi F, et al. Prospective study to assess risk factors for pelvic floor dysfunction after delivery. Acta Obstet Gynecol Scand. 2008;87(3):313–8.

    PubMed  Google Scholar 

  25. Gyhagen M, Milsom I. Prevalence of urinary incontinence 20 years after childbirth in a national cohort study in singleton primiparae after vaginal or caesarean delivery--authors' reply. BJOG. 2013;120(9):1150–1.

    CAS  PubMed  Google Scholar 

  26. Press JZ, Klein MC, Kaczorowski J, Liston RM, von Dadelszen P. Does cesarean section reduce postpartum urinary incontinence? A systematic review. Birth. 2007;34(3):228–37.

    PubMed  Google Scholar 

  27. Serati M, Di Dedda MC, Bogani G, Sorice P, Cromi A, Uccella S, et al. Position in the second stage of labour and de novo onset of post-partum urinary incontinence. Int Urogynecol J. 2016;27(2):281–6.

    PubMed  Google Scholar 

  28. Gupta JK, Sood A, Hofmeyr GJ, Vogel JP. Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database Syst Rev. 2017;5:CD002006.

    PubMed  Google Scholar 

  29. Buchsbaum GM, Chin M, Glantz C, Guzick D. Prevalence of urinary incontinence and associated risk factors in a cohort of nuns. Obstet Gynecol. 2002;100(2):226–9.

    PubMed  Google Scholar 

  30. Buchsbaum GM, Duecy EE, Kerr LA, Huang LS, Guzick DS. Urinary incontinence in nulliparous women and their parous sisters. Obstet Gynecol. 2005;106(6):1253–8.

    PubMed  Google Scholar 

  31. Cody JD, Jacobs ML, Richardson K, Moehrer B, Hextall A. Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database Syst Rev. 2012;10:CD001405.

    PubMed  Google Scholar 

  32. • Hendrix SL, Cochrane BB, Nygaard IE, Handa VL, Barnabei VM, Iglesia C, et al. Effects of estrogen with and without progestin on urinary incontinence. JAMA. 2005;293(8):935–48 Large RCT showing that administration of conjugated equine estrogen could lead to worsening incontinence.

    CAS  PubMed  Google Scholar 

  33. Altman D, Granath F, Cnattingius S, Falconer C. Hysterectomy and risk of stress-urinary-incontinence surgery: nationwide cohort study. Lancet. 2007;370(9597):1494–9.

    PubMed  Google Scholar 

  34. Forsgren C, Lundholm C, Johansson AL, Cnattingius S, Zetterstrom J, Altman D. Vaginal hysterectomy and risk of pelvic organ prolapse and stress urinary incontinence surgery. Int Urogynecol J. 2012;23(1):43–8.

    PubMed  Google Scholar 

  35. • Lamerton TJ, Torquati L, Brown WJ. Overweight and obesity as major, modifiable risk factors for urinary incontinence in young to mid-aged women: a systematic review and meta-analysis. Obes Rev. 2018;19(12):1735–45 Recent meta-analysis showing the association with being overweight or obese with worse urinary incontinence.

    CAS  PubMed  Google Scholar 

  36. Lawrence JM, Lukacz ES, Liu IL, Nager CW, Luber KM. Pelvic floor disorders, diabetes, and obesity in women: findings from the Kaiser Permanente continence associated risk epidemiology study. Diabetes Care. 2007;30(10):2536–41.

    PubMed  Google Scholar 

  37. Subak LL, Whitcomb E, Shen H, Saxton J, Vittinghoff E, Brown JS. Weight loss: a novel and effective treatment for urinary incontinence. J Urol. 2005;174(1):190–5.

    PubMed  PubMed Central  Google Scholar 

  38. • Subak LL, Wing R, West DS, Franklin F, Vittinghoff E, Creasman JM, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360(5):481–90 Large RCT that showed the effectiveness of a 6 month diet and exercise program in reduction in incontinence symptoms.

    CAS  PubMed  PubMed Central  Google Scholar 

  39. Brown JS, Wing R, Barrett-Connor E, Nyberg LM, Kusek JW, Orchard TJ, et al. Lifestyle intervention is associated with lower prevalence of urinary incontinence: the Diabetes Prevention Program. Diabetes Care. 2006;29(2):385–90.

    PubMed  PubMed Central  Google Scholar 

  40. Phelan S, Kanaya AM, Ma Y, Vittinghoff E, Barrett-Connor E, Wing R, et al. Long-term prevalence and predictors of urinary incontinence among women in the Diabetes Prevention Program Outcomes Study. Int J Urol. 2015;22(2):206–12.

    PubMed  Google Scholar 

  41. Lee Y, Yu J, Tikkinen KAO, Pedziwiatr M, Major P, Aditya I, et al. The impact of bariatric surgery on urinary incontinence: a systematic review and meta-analysis. BJU Int. 2019;124(6):917–34.

    PubMed  Google Scholar 

  42. Lian W, Zheng Y, Huang H, Chen L, Cao B. Effects of bariatric surgery on pelvic floor disorders in obese women: a meta-analysis. Arch Gynecol Obstet. 2017;296(2):181–9.

    PubMed  Google Scholar 

  43. Burgio KL, Richter HE, Clements RH, Redden DT, Goode PS. Changes in urinary and fecal incontinence symptoms with weight loss surgery in morbidly obese women. Obstet Gynecol. 2007;110(5):1034–40.

    PubMed  Google Scholar 

  44. Solanki NS, Duffield JA, Dean NR, Morgan RG. The effect of abdominoplasty on urinary incontinence in women. Plast Reconstr Surg. 2010;126(4):206e–9e.

    PubMed  Google Scholar 

  45. Wang R, Lefevre R, Hacker MR, Golen TH. Diabetes, glycemic control, and urinary incontinence in women. Female Pelvic Med Reconstr Surg. 2015;21(5):293–7.

    PubMed  PubMed Central  Google Scholar 

  46. Teixeira RV, Colla C, Sbruzzi G, Mallmann A, Paiva LL. Prevalence of urinary incontinence in female athletes: a systematic review with meta-analysis. Int Urogynecol J. 2018;29(12):1717–25.

    PubMed  Google Scholar 

  47. Eliasson K, Larsson T, Mattsson E. Prevalence of stress incontinence in nulliparous elite trampolinists. Scand J Med Sci Sports. 2002;12(2):106–10.

    CAS  PubMed  Google Scholar 

  48. Nygaard IE, Shaw JM, Bardsley T, Egger MJ. Lifetime physical activity and female stress urinary incontinence. Am J Obstet Gynecol. 2015;213(1):40 e1–e10.

    Google Scholar 

  49. Tahtinen RM, Auvinen A, Cartwright R, Johnson TM 2nd, Tammela TL, Tikkinen KA. Smoking and bladder symptoms in women. Obstet Gynecol. 2011;118(3):643–8.

    PubMed  Google Scholar 

  50. Dallosso HM, McGrother CW, Matthews RJ, Donaldson MM, Leicestershire MRCISG. The association of diet and other lifestyle factors with overactive bladder and stress incontinence: a longitudinal study in women. BJU Int. 2003;92(1):69–77.

    CAS  PubMed  Google Scholar 

  51. Bump RC, McClish DK. Cigarette smoking and urinary incontinence in women. Am J Obstet Gynecol. 1992;167(5):1213–8.

    CAS  PubMed  Google Scholar 

  52. Tampakoudis P, Tantanassis T, Grimbizis G, Papaletsos M, Mantalenakis S. Cigarette smoking and urinary incontinence in women--a new calculative method of estimating the exposure to smoke. Eur J Obstet Gynecol Reprod Biol. 1995;63(1):27–30.

    CAS  PubMed  Google Scholar 

  53. Samuelsson E, Victor A, Svardsudd K. Determinants of urinary incontinence in a population of young and middle-aged women. Acta Obstet Gynecol Scand. 2000;79(3):208–15.

    CAS  PubMed  Google Scholar 

  54. Townsend MK, Lajous M, Medina-Campos RH, Catzin-Kuhlmann A, Lopez-Ridaura R, Rice MS. Risk factors for urinary incontinence among postmenopausal Mexican women. Int Urogynecol J. 2017;28(5):769–76.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E. Ann Gormley.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Female Urology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Swanton, A.R., Gormley, E.A. Prevention of Urinary Incontinence in Women. Curr Urol Rep 21, 43 (2020). https://doi.org/10.1007/s11934-020-00988-x

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11934-020-00988-x

Keywords

Navigation