Sedentary Behaviour and Female Urinary Incontinence. A Systematic Review with Subtype-Specific analysis

To systematically evaluate the association between sedentary behaviour and female urinary incontinence (UI), with emphasis on subtype-specific outcomes (stress UI [SUI], urgency UI [UUI], mixed UI [MUI]), assessment methods, and confounding factors.

Systematic review following PRISMA 2020 guidelines. Observational studies (cross-sectional, cohort, case-control) published in English, French or Spanish (2010-2026) were identified via PubMed, Cochrane, and PEDro. Eligible studies assessed sedentary behaviour (objective/self-reported) and UI in women, excluding non-original research. Risk of bias was assessed using revised JBI tools, and evidence certainly was evaluated with GRADE.

Eight studies (n=35-10,768 participants) met inclusion criteria. Greater sedentary exposure was generally associated with higher UI prevalence or severity, particularly for UUI (low-certainty evidence). Associations with UUI and UI severity appeared more consistent in accelerometry-based studies than in studies using self-reported measures, but this limited evidence does not establish that objective measures yield stronger associations. For SUI, findings were inconsistent (very low-certainty evidence). Adjusted analyses (controlling for age, BMI, parity, physical activity) often attenuated associations, though some remained significant. Heterogeneity in UI definitions, sedentary assessment, and confounders limited meta-analysis.

Sedentary behaviour appears associated with UUI in women, but the direction of the association cannot be established and reverse causation is plausible. Evidence for SUI is inconclusive. Prospective studies using objective measures and subtype-specific outcomes are needed to establish temporal ordering.