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Patient Decision Aids for Women With Urinary Incontinence: A Systematic Review.

Tsung Mou1, Emily Bulczynski2, Hailey Greenstone2

  • 1Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, Tufts University School of Medicine and Tufts Medical Center.

Urogynecology (Philadelphia, Pa.)
|May 21, 2026
PubMed
Summary
This summary is machine-generated.

Patient decision aids for urinary incontinence (UI) in women primarily aid treatment selection in specialty care. Evidence for improved knowledge or communication is limited, and future aids should cover the full care continuum.

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Area of Science:

  • Urology
  • Women's Health
  • Decision Science

Background:

  • Women with urinary incontinence (UI) face critical decisions throughout their care journey.
  • Patient decision aids (PDAs) show potential to support these choices.
  • The availability, effectiveness, and quality of PDAs for UI require systematic evaluation.

Purpose of the Study:

  • To evaluate the availability, effectiveness, and quality of patient decision aids (PDAs) for women with urinary incontinence (UI).
  • To assess PDAs based on the International Patient Decision Aid Standards (IPDAS) framework.

Main Methods:

  • Systematic review and meta-analysis adhering to PRISMA guidelines.
  • Searched major databases (MEDLINE, Embase, CINAHL, Web of Science, Cochrane Central) from 2005 to February 2026.
  • Included studies evaluating PDAs for stress, urgency, or mixed UI, focusing on decision-making process, choice attributes, and health service outcomes.

Main Results:

  • Nine studies involving 956 women were included; all PDAs focused on treatment selection in specialty care.
  • PDAs were associated with reduced decisional conflict, but evidence for improved knowledge, communication, or satisfaction was lacking.
  • High risk of bias was noted due to nonrandomized designs, despite most studies meeting IPDAS criteria.

Conclusions:

  • Current PDAs for women's UI primarily address treatment selection in specialty settings.
  • Existing PDAs do not demonstrate a causal effect on reducing decision conflict or address the initial decision to seek care.
  • Future PDAs should encompass the entire UI care continuum and undergo rigorous evaluation.