Sarcopenia and Female Lower Urinary Tract Symptoms: A Systematic Review

To systematically review the current evidence regarding the association between sarcopenia and female lower urinary tract symptoms (LUTS), with a focus on epidemiological findings, potential pathophysiological mechanisms, and clinical implications.

A systematic literature search of PubMed was conducted for studies published between January 2010 and June 2026 following the PRISMA 2020 guidelines. Observational studies evaluating the relationship between sarcopenia, muscle-related parameters, or frailty and female LUTS were included. Data on study characteristics, sarcopenia assessment, LUTS outcomes, and principal findings were extracted and synthesized narratively. Methodological quality was assessed using the Newcastle-Ottawa Scale.

Twenty studies met the inclusion criteria. Most were cross-sectional studies involving community-dwelling or older women. Consistent evidence demonstrated significant associations between sarcopenia and multiple LUTS subtypes, including stress urinary incontinence, UUI, overactive bladder, nocturia, and overall LUTS burden. Recent studies further identified trunk muscle deficiency and sarcopenic obesity as potential contributors to urinary incontinence, while frailty was consistently associated with storage symptoms and functional decline. Owing to substantial heterogeneity in study populations, diagnostic criteria, and outcome measures, quantitative meta-analysis was not performed.

Current evidence suggests that sarcopenia is associated with a broad spectrum of female LUTS through multiple interconnected mechanisms, including pelvic floor muscle dysfunction, trunk muscle deficiency, sarcopenic obesity, and frailty. Assessment of muscle health may improve risk stratification and facilitate multidisciplinary management of women with LUTS. Prospective longitudinal studies are warranted to clarify causality and evaluate whether interventions targeting sarcopenia can improve urinary outcomes.