Urinary incontinence in Turkish women: associated factors and impact on quality of life in a hospital-based case–control study

Mustafa Behram; Emrullah Akay

Urinary incontinence in Turkish women: associated factors and impact on quality of life in a hospital-based case–control study

Abstract

Aims: This study aimed to identify factors associated with urinary incontinence (UI) in Turkish women and to evaluate its impact on quality of life using the King’s Health Questionnaire (KHQ). Methods: This hospital-based case–control study included 546 women with UI and 546 women without UI, all aged 18 years or older. Participants completed a questionnaire covering demographic, obstetric, and lifestyle factors, as well as the KHQ. Results: The UI group had a significantly higher mean age, as well as increased gravidity and parity, macrosomic birth (≥4,000 g), chronic pelvic pain, hypothyroidism, recurrent urinary tract infections, and tobacco and coffee consumption. Conversely, hyperthyroidism was more prevalent in the non-UI group. The proportions of women with a history of vaginal delivery or cesarean section were similar between groups, whereas the numbers of vaginal births and cesarean sections were significantly higher among women with UI. KHQ scores were markedly elevated in participants with UI, particularly in domains related to daily function and social limitations, indicating a substantial negative impact on quality of life. Conclusion: UI is a significant public health issue that negatively affects quality of life among Turkish women. In multivariable analysis, advanced age, higher gravidity, macrosomic birth history, chronic pelvic pain, hypothyroidism, recurrent urinary tract infections, and tobacco use were independently associated with UI, whereas hyperthyroidism and family history of UI showed inverse associations. Our findings also demonstrated that UI substantially impairs social functioning, physical activities, and emotional well-being, as reflected by the KHQ subscale scores.

Keywords

Supporting Institution

None.

Project Number

None

Ethical Statement

Ethics Committee Approval: This study was approved by the Başakşehir Çam and Sakura City Hospital Clinical Research Ethics Committee, Istanbul, Türkiye (Date: November 13, 2024; Decision No: KAEK-11/231).

Thanks

None

References

Abufaraj M, Xu T, Cao C, et al. Prevalence and trends in urinary incontinence among women in the United States, 2005-2018. Am J Obstet Gynecol. 2021;225(2):166.e1-166.e12. doi:10.1016/j.ajog.2021.03.016
Alsannan B, Alharmi J, Alrahal F, Al Mansoor S, Tulandi T. Prevalence and quality of life among overweight and obese women with different severity and types of urinary incontinence. Med Princ Pract. 2024;33(1): 47-55. doi:10.1159/000534651
Babini D, Lemos A. Risk factors for urinary incontinence in primiparous adolescents after vaginal delivery: a cohort study. J Pediatr Adolesc Gynecol. 2020;33(5):500-505. doi:10.1016/j.jpag.2020.06.011
Khullar V, Sexton CC, Thompson CL, Milsom I, Bitoun CE, Coyne KS. The relationship between BMI and urinary incontinence subgroups: results from EpiLUTS. Neurourol Urodyn. 2014;33(3):392-399. doi:10.1002/nau.22428
Pang H, Lv J, Xu T, et al. Incidence and risk factors of female urinary incontinence: a 4-year longitudinal study among 24,985 adult women in China. BJOG. 2022;129(4):580-589. doi:10.1111/1471-0528.16936
Wang Q, Que Y, Yang Y, Wan X, Lin C. A population-based cross-sectional survey on the prevalence, severity, risk factors, and self-perception of female urinary incontinence in rural Fujian, China. Int Urogynecol J. 2023;34(9):2089-2097. doi:10.1007/s00192-023-05518-0
Xue K, Palmer MH, Zhou F. Prevalence and associated factors of urinary incontinence in women living in China: a literature review. BMC Urol. 2020;20(1):159. doi:10.1186/s12894-020-00735-x
Cheng H, Gong F, Shen Y, OuYang P, Ni R, Gao H. A nomogram model predicting the risk of postpartum stress urinary incontinence in primiparas: a multicenter study. Taiwan J Obstet Gynecol. 2022;61(5): 580-584. doi:10.1016/j.tjog.2022.04.004

Gallego-Gómez C, Rodríguez-Gutiérrez E, Torres-Costoso A, et al. Urinary incontinence increases risk of postpartum depression: systematic review and meta-analysis. Am J Obstet Gynecol. 2024;231(3): 296-307. doi:10.1016/j.ajog.2024.02.307
High RA, Alvarez M, Champion B, Anger J, Handa VL. Longitudinal study of cognitive decline among women with and without urinary incontinence. Am J Obstet Gynecol. 2024;231(1):105.e1-105.e8. doi:10.1016/j.ajog.2024.02.305
Furuyama W, Kaufman M, Dmochowski R, Reynolds WS, Sebesta E. Social vulnerability is associated with worse urinary incontinence and quality of life in women. Urology. 2025;197:71-76. doi:10.1016/j.urology.2024.11.034
Basak T, Kok G, Guvenc G. Prevalence, risk factors and quality of life in Turkish women with urinary incontinence: a synthesis of the literature. Int Nurs Rev. 2013;60(4):448-460. doi:10.1111/inr.12048
Yavuz M, Etiler N. Addressing urinary incontinence by gender: a nationwide population-based study in Turkiye. BMC Urol. 2023;23(1): 205. doi:10.1186/s12894-023-01388-2
Kaya S, Akbayrak T, Toprak Çelenay Ş, Dolgun A, Ekici G, Beksaç S. Reliability and validity of the Turkish King’s Health Questionnaire in women with urinary incontinence. Int Urogynecol J. 2015;26(12):1853-1859. doi:10.1007/s00192-015-2786-6
Filiz TM, Uludağ C, Çınar N, Gorpelioğlu S, Topsever P. Risk factors for urinary incontinence in Turkish women: a cross-sectional study. Saudi Med J. 2006;27(11):1688-1692.
Yağmur Y, Gül S. Urinary incontinence in women aged 40 and older: its prevalence, risk factors, and effect on quality of life. Niger J Clin Pract. 2021;24(2):186-192. doi:10.4103/njcp.njcp_626_18
Dai S, Chen H, Luo T. Prevalence and factors of urinary incontinence among postpartum: systematic review and meta-analysis. BMC Pregnancy Childbirth. 2023;23:761. doi:10.1186/s12884-023-06059-6
Hirakawa T, Suzuki S, Kato K, Gotoh M, Yoshikawa Y. Randomized controlled trial of pelvic floor muscle training with or without biofeedback for urinary incontinence. Int Urogynecol J. 2013;24(8):1347-1354. doi:10.1007/s00192-012-2012-8
Al-Mukhtar Othman J, Åkervall S, Nilsson IEK, Molin M, Milsom I, Gyhagen M. Fecal incontinence in nonpregnant nulliparous women aged 25 to 64 years—a randomly selected national cohort prevalence study. Am J Obstet Gynecol. 2022;226(5):706.e1-706.e23. doi:10.1016/j.ajog.2021.11.032
Novo R, Perez-Rios M, Santiago-Pérez MI, Butler H, Malvar A, Hervada X. Prevalence and associated risk factors of urinary incontinence and dyspareunia during pregnancy and after delivery. Eur J Obstet Gynecol Reprod Biol. 2020;245:45-50. doi:10.1016/j.ejogrb.2019.10.020
Button BM, Holland AE, Sherburn MS, Chase J, Wilson JW, Burge AT. Prevalence, impact, and specialised treatment of urinary incontinence in women with chronic lung disease. Physiotherapy. 2019;105(1):114-119. doi:10.1016/j.physio.2018.07.006
Gleason JL, Richter HE, Redden DT, Goode PS, Burgio KL, Markland AD. Caffeine and urinary incontinence in US women. Int Urogynecol J. 2013;24(2):295-302. doi:10.1007/s00192-012-1829-5
Wagg A. Managing pelvic floor dysfunction and incontinence in the frail older woman. Obstet Gynaecol Reprod Med. 2024;34(5):113-118. doi:10.1016/j.ogrm.2024.01.005
Karapolat H, Akkoç Y, Eyigör S, Tanıgör G. Bladder-related quality of life in people with neurological disorders: reliability and validity of the Turkish version of the King’s Health Questionnaire in people with spinal cord injury. Turk J Urol. 2018;44(5):411-417. doi:10.5152/tud.2018.45556
Kelleher CJ, Cardozo LD, Khullar V, Salvatore S. A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol. 1997;104(12):1374-1379. doi:10.1111/j.1471-0528.1997.tb11006.x
Pintos-Díaz MZ, Alonso-Blanco C, Parás-Bravo P, et al. Living with urinary incontinence: potential risks of women's health? A qualitative study on the perspectives of female patients seeking care for the first time in a specialized center. Int J Environ Res Public Health. 2019;16(19):3781. doi:10.3390/ijerph16193781
Kowalski JT, Wiseman JB, Smith AR, et al. Natural history of lower urinary tract symptoms in treatment-seeking women with pelvic organ prolapse; the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN). Am J Obstet Gynecol. 2022;227(6):875.e1-875.e12. doi:10.1016/j.ajog.2022.07.038
Parker-Autry C, Kuchel GA. Urinary incontinence in older women: a syndrome-based approach to addressing late life heterogeneity. Obstet Gynecol Clin North Am. 2021;48(4):665-675. doi:10.1016/j.ogc.2021.05.017
Vasconcelos VS de, Ribeiro da Costa AA. Frequency and factors associated with urinary incontinence in pregnant adolescents: a cross-sectional study. J Pediatr Adolesc Gynecol. 2021;34(4):366-376. doi:10.1016/j.jpag.2020.12.013
Martinez A, Rodriguez MA, Al Snih S. Factors associated with urgency urinary incontinence among older Mexican American women aged 65 years and older. Gerontol Geriatr Med. 2022;8:23337214221119061. doi:10.1177/23337214221119061
Karaçam Z, Özsoy S, Özer Yurdal NE. The prevalence of urinary incontinence and risk factors in menopausal women in Turkey: a systematic review and meta-analysis. Int J Urol Nurs. 2024;18:e12382. doi:10.1111/ijun.12382
Akay E, Güler OM, Bayraktar HK, Gül ADU, Türkoğlu A. Psychometric validity and reliability of the Turkish version of the questionnaire for urinary incontinence diagnosis in women with urinary incontinence. BMC Womens Health. 2025;25(1):197. doi:10.1186/s12905-025-03730-2

Details

Primary Language

English

Subjects

Obstetrics and Gynaecology

Journal Section

Research Article

Authors

Mustafa Behram
0000-0003-0461-263X
Türkiye

Emrullah Akay ^*
0000-0003-3792-7777
Türkiye

Publication Date

October 25, 2026

Submission Date

July 16, 2026

Acceptance Date

August 17, 2026

Published in Issue

Year 2026 Volume: 7 Number: 5

IZ

https://izlik.org/JA78FH34PT

Cite

RIS / Bibtex

APA

Behram, M., & Akay, E. (2026). Urinary incontinence in Turkish women: associated factors and impact on quality of life in a hospital-based case–control study. Journal of Medicine and Palliative Care, 7(5), 904-910. https://izlik.org/JA78FH34PT

AMA

1.Behram M, Akay E. Urinary incontinence in Turkish women: associated factors and impact on quality of life in a hospital-based case–control study. J Med Palliat Care / JOMPAC / jompac. 2026;7(5):904-910. https://izlik.org/JA78FH34PT

Chicago

Behram, Mustafa, and Emrullah Akay. 2026. “Urinary Incontinence in Turkish Women: Associated Factors and Impact on Quality of Life in a Hospital-Based Case–control Study”. Journal of Medicine and Palliative Care 7 (5): 904-10. https://izlik.org/JA78FH34PT.

EndNote

Behram M, Akay E (October 1, 2026) Urinary incontinence in Turkish women: associated factors and impact on quality of life in a hospital-based case–control study. Journal of Medicine and Palliative Care 7 5 904–910.

IEEE

[1]M. Behram and E. Akay, “Urinary incontinence in Turkish women: associated factors and impact on quality of life in a hospital-based case–control study”, J Med Palliat Care / JOMPAC / jompac, vol. 7, no. 5, pp. 904–910, Oct. 2026, [Online]. Available: https://izlik.org/JA78FH34PT

ISNAD

Behram, Mustafa - Akay, Emrullah. “Urinary Incontinence in Turkish Women: Associated Factors and Impact on Quality of Life in a Hospital-Based Case–control Study”. Journal of Medicine and Palliative Care 7/5 (October 1, 2026): 904-910. https://izlik.org/JA78FH34PT.

JAMA

1.Behram M, Akay E. Urinary incontinence in Turkish women: associated factors and impact on quality of life in a hospital-based case–control study. J Med Palliat Care / JOMPAC / jompac. 2026;7:904–910.

MLA

Behram, Mustafa, and Emrullah Akay. “Urinary Incontinence in Turkish Women: Associated Factors and Impact on Quality of Life in a Hospital-Based Case–control Study”. Journal of Medicine and Palliative Care, vol. 7, no. 5, Oct. 2026, pp. 904-10, https://izlik.org/JA78FH34PT.

Vancouver

1.Mustafa Behram, Emrullah Akay. Urinary incontinence in Turkish women: associated factors and impact on quality of life in a hospital-based case–control study. J Med Palliat Care / JOMPAC / jompac [Internet]. 2026 Oct. 1;7(5):904-10. Available from: https://izlik.org/JA78FH34PT