The prevalence of urinary incontinence and risk factors in menopausal women in Turkey: A systematic review and meta-analysis

This study was conducted to determine the prevalence and risk factors of urinary incontinence in menopausal women. This systematic review and meta-analysis followed PRISMA and COSMOS-E guidelines. The searches were conducted on 1-15 April, 2022 using PubMed, EBSCO, Embase, PsycINFO, DOAJ, Web of Science, DergiPark, Scopus, Turkish Medline, Turkish Citation Index, TR Index and National Thesis Center search engines. The keywords 'menopause, climacteric, urinary incontinence, risk factors, prevalence' were used in the searches. The risk of bias was assessed using the Critical Appraisal Checklist for cross-sectional studies developed by the Joanna Briggs Institute. Data were synthesized by meta-analysis, meta-regression and narrative methods. Eleven studies published between 2012 and 2022 were included. The total sample size of the studies was 2531. In this meta-analysis, the estimated rate of urinary incontinence in women aged 40-65 years was 46.9% (95% CI: 0.346-0.595), and this result was statistically significantly affected by the moderator variables risk of bias (Q = 8.76, p = 0.013) and urinary incontinence diagnostic tools (Q = 27.60, p < 0.001). The estimated stress urinary incontinence rate was 19.1% (95% CI: 0.130-0.271), urge urinary incontinence rate was 5.1% (95% CI: 0.020-0.124) and the mixed urinary incontinence rate was 13.4% (95% CI: 0.092-0.192). The risk factors affecting urinary incontinence were found to be advanced age, menopause, diabetes mellitus, constipation, obesity, history of urinary incontinence during pregnancy and the postpartum period, mode of delivery, four or more births, urinary tract infection, family history of urinary incontinence and genetic predisposition. This meta-analysis revealed that urinary incontinence and its types are highly prevalent in women aged 40-65 years and that the prevalence is influenced by the quality of research and the type of diagnostic tool used in addition to many risk factors. Planning and offering appropriate health care services based on these results could contribute to the protection and improvement of women's health.