A systematic review of the prevalence and impact of urinary incontinence in cystic fibrosis

Abstract

This systematic review synthesizes published articles investigating the prevalence, severity and impact of urinary incontinence (UI), a condition associated with cystic fibrosis (CF). References were identified through searching Medline, Embase and PubMed using the medical subject headings 'cystic fibrosis' AND 'urinary incontinence'. Articles were included if UI prevalence was investigated as an outcome. Twelve studies met selection criteria. The prevalence of UI ranged from 5% to 76%. Age and gender contributed to this variability. When assessed, UI commonly limited airway clearance, exercise and/or spirometry, and had a variable impact on patients' lives. Worry and embarrassment were features for many; others were less affected. In CF, UI is common and can interfere with respiratory care and social well-being. The prevalence, characteristics and impact are poorly understood, which is made worse by inconsistent definitions across studies. Future research is needed to improve approaches to prevention, identification, management and education.

Prevalence and factors associated with urinary incontinence in females with cystic fibrosis: An Italian single‐center cross‐sectional analysis

“…Mild UI was reported in the majority of adult women, that is, 64%, in agreement with other previous reports which classified the severity of the disorder based on the frequency of leaks, 1,6 on the combination of frequency and quantity of lost urine 9 or on the basis of the score of the questionnaire used 30 . Cough (82%) and exercise (28%) were identified as the main triggers of UI in adult females, confirming that stress incontinence is the most common type of UI in patients with CF 3 . It is well known that contraction of abdominal muscles during cough leads to a rapid rise in intrabdominal pressure, exposing people with chronic lung disease to a higher risk of developing UI.…”

“…In the present study we also observed a higher nutritional status in females with incontinence and a higher risk of UI as BMI increases, despite other studies failed to show any evidence of difference between females with and without UI or any relationship between UI and body mass in patients with CF. 3,22,32 A positive association between prevalence of UI and obesity has been well documented in the healthy population, 33 resulting from the relationship between BMI, intra-abdominal and intra-vesical pressures. In our series of patients with UI, 36% (14/39) of adults have BMI ≥ 22 kg/m 2 and 8% (1/12) of children and adolescents have BMI equal to 0 Z score.…”

“…5,[7][8][9][10] In general, UI prevails in 30%-76% of females with CF. 3 Due to the considerable social and psychological impact of UI on lifestyle, 1,7 we aimed to determine the prevalence of UI in the population attending our large CF center by means of two validated instruments to screen UI in adults and children. The secondary objective was to assess the association between UI and CF disease severity.…”

Abstracts from the 23rd Italian congress of Cystic Fibrosis and the 13th National congress of Cystic Fibrosis Italian Society

“…In CF, UI is common and can interfere with respiratory care, daily activities and quality of life. In CF literature, there aren't evidences of routine assessment of UI or approaches standardization to identifying UI between different CF centres [5]. In our clinical experience patients do not report UI presence and their discomfort.…”

Female reproductive health in cystic fibrosis

“…Urinary incontinence is also common in females with CF [78]. As a result, women can be hesitant to perform chest physiotherapy and/or spirometry, and the incontinence may also inhibit their social activities.…”