Physiotherapy - Reviews

Prevalence of urinary incontinence in patients with chronic cough: a systematic review

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: 10 October 2025
Published: 12 February 2026
1187
Views
516
Downloads

Authors

Chronic cough-related diseases increase the risk of urinary incontinence (UI) due to repeated intra-abdominal pressure affecting the pelvic floor. Existing studies focus on specific diseases rather than UI as a broader consequence. To determine the prevalence of UI in patients with chronic cough-related diseases and compare it with the prevalence in healthy populations. A systematic review was conducted using Medline, Embase, Cochrane, OVID, Scopus, ProQuest, PEDro, and EBSCO. Two independent reviewers screened studies using predefined criteria in a Microsoft Excel spreadsheet. Only prevalence studies were included. Data were extracted, synthesized, and assessed using the GRADE approach for evidence quality and the STROBE checklist for reporting quality. Prevalence estimates varied widely based on demographic characteristics. UI prevalence ranged from 2.2% to 45% in pediatric patients, 30.4% to 74% in adult women, and 2.4% to 39% in adult men. The quality of evidence was low, while reporting quality was acceptable. UI is a common complication in patients with chronic cough, with a higher prevalence than in healthy populations. Due to the stigma surrounding urogenital disorders, clinicians should actively inquire about UI during patient history-taking and refer affected individuals for appropriate treatment.

Downloads

Download data is not yet available.

GBD 2019 Chronic Respiratory Diseases Collaborators. Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019. eClinicalMedicine 2023;59:101936.

Abozid H, Patel J, Burney P, et al. Prevalence of chronic cough, its risk factors and population attributable risk in the Burden of Obstructive Lung Disease (BOLD) study: a multinational cross-sectional study. eClinicalMedicine 2024;68:102423. DOI: https://doi.org/10.1016/j.eclinm.2024.102423

Chung KF, Pavord ID. Prevalence, pathogenesis, and causes of chronic cough. Lancet 2008;371:1364-74. DOI: https://doi.org/10.1016/S0140-6736(08)60595-4

Cobb WS, Burns JM, Kercher KW, et al. Normal intraabdominal pressure in healthy adults. J Surg Res 2005;129:231-5. DOI: https://doi.org/10.1016/j.jss.2005.06.015

Canning BJ. Anatomy and neurophysiology of the cough reflex. Chest 2006;129:33S-47. DOI: https://doi.org/10.1378/chest.129.1_suppl.33S

Lasak AM, Jean‐Michel M, Le PU, et al. The role of pelvic floor muscle training in the conservative and surgical management of female stress urinary incontinence: does the strength of the pelvic floor muscles matter? PM R 2018;10:1198-210. DOI: https://doi.org/10.1016/j.pmrj.2018.03.023

Hrisanfow E, Hägglund D. The prevalence of urinary incontinence among women and men with chronic obstructive pulmonary disease in Sweden. J Clin Nurs 2011;20:1895-905. DOI: https://doi.org/10.1111/j.1365-2702.2010.03660.x

McVean RJ, Orr A, Webb AK, et al. Treatment of urinary incontinence in cystic fibrosis. J Cyst Fibros 2003;2:171-6. DOI: https://doi.org/10.1016/S1569-1993(03)00088-2

Hwang UJ, Lee MS, Jung SH, et al. Effect of pelvic floor electrical stimulation on diaphragm excursion and rib cage movement during tidal and forceful breathing and coughing in women with stress urinary incontinence: a randomized controlled trial. Medicine 2021;100:e24158. DOI: https://doi.org/10.1097/MD.0000000000024158

Munn Z, Stern C, Aromataris E, et al. What kind of systematic review should I conduct? A proposed typology and guidance for systematic reviewers in the medical and health sciences. BMC Med Res Methodol 2018;18:5. DOI: https://doi.org/10.1186/s12874-017-0468-4

Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;n71. DOI: https://doi.org/10.1136/bmj.n71

Blackwell K, Malone PSJ, Denny A, et al. The prevalence of stress urinary incontinence in patients with cystic fibrosis: an under-recognized problem. J Pediatr Urol 2005;1:5-9. DOI: https://doi.org/10.1016/j.jpurol.2004.07.001

Browne WJ, Wood CJ, Desai M, Weller PH. Urinary incontinence in 9–16 year olds with cystic fibrosis compared to other respiratory conditions and a normal group. J Cyst Fibros 2009;8:50-7. DOI: https://doi.org/10.1016/j.jcf.2008.09.002

Burge AT, Holland AE, Sherburn M, et al. Prevalence and impact of urinary incontinence in men with cystic fibrosis. Physiotherapy 2015;101:166-70. DOI: https://doi.org/10.1016/j.physio.2014.11.001

Burge AT, Lee AL, Kein C, et al. Prevalence and impact of urinary incontinence in men with chronic obstructive pulmonary disease: a questionnaire survey. Physiotherapy 2017;103:53-8. DOI: https://doi.org/10.1016/j.physio.2015.11.004

Button BM, Holland AE, Sherburn MS, et al. Prevalence, impact and specialised treatment of urinary incontinence in women with chronic lung disease. Physiotherapy 2019;105:114-9. DOI: https://doi.org/10.1016/j.physio.2018.07.006

Cornacchia M, Zenorini A, Perobelli S, et al. Prevalence of urinary incontinence in women with cystic fibrosis. BJU Int 2001;88:44-8. DOI: https://doi.org/10.1046/j.1464-410x.2001.02242.x

Dicpinigaitis PV. Prevalence of stress urinary incontinence in women presenting for evaluation of chronic cough. ERJ Open Res 2021;7:00012-2021. DOI: https://doi.org/10.1183/23120541.00012-2021

Hirayama F, Lee AH, Binns CW, et al. Urinary incontinence in men with chronic obstructive pulmonary disease. Int J Urol 2008;15:751-3. DOI: https://doi.org/10.1111/j.1442-2042.2008.02093.x

Hrisanfow E, Hägglund D. Impact of cough and urinary incontinence on quality of life in women and men with chronic obstructive pulmonary disease. J Clin Nurs 2013;22:97-105. DOI: https://doi.org/10.1111/j.1365-2702.2012.04143.x

Hubeaux K, Gueganton L, Nowak E, et al. Prevalence and severity of functional urinary and anorectal disorders and their impact on quality of life in cystic fibrosis. J Cyst Fibros 2024;23:579-86. DOI: https://doi.org/10.1016/j.jcf.2023.10.011

22. Korzeniewska-Eksterowicz A, Stelmach I, Stelmach W. Urinary incontinence in adolescent females with cystic fibrosis in Poland. Open Med 2014;9:778-83. DOI: https://doi.org/10.2478/s11536-013-0331-x

23. Mariani A, Gambazza S, Carta F, et al. Prevalence and factors associated with urinary incontinence in females with cystic fibrosis: an Italian single‐center cross‐sectional analysis. Pediatr Pulmonol 2022;57:132-41. DOI: https://doi.org/10.1002/ppul.25723

Moran F, Bradley J, Boyle L, Elborn J. Incontinence in adult females with cystic fibrosis: a northern Ireland survey. Int J Clin Pract 2003;57:182-3. DOI: https://doi.org/10.1111/j.1742-1241.2003.tb10460.x

Nixon GM, Glazner JA, Martin JM, Sawyer SM. Urinary incontinence in female adolescents with cystic fibrosis. Pediatrics 2002;110:e22. DOI: https://doi.org/10.1542/peds.110.2.e22

Orr A. Questionnaire survey of urinary incontinence in women with cystic fibrosis. BMJ 2001;322:1521. DOI: https://doi.org/10.1136/bmj.322.7301.1521

Prasad SA, Balfour‐Lynn IM, Carr SB, Madge SL. A comparison of the prevalence of urinary incontinence in girls with cystic fibrosis, asthma, and healthy controls. Pediatr Pulmonol 2006;41:1065-8. DOI: https://doi.org/10.1002/ppul.20493

Reichman G, De Boe V, Braeckman J, Michielsen D. Urinary incontinence in patients with cystic fibrosis. Scand J Urol 2016;50:128-31. DOI: https://doi.org/10.3109/21681805.2015.1096826

Sacomori C, Guerrero-González M, Cabrera-González C, et al. Factors influencing quality of life in patients with asthma or chronicobstructive pulmonary disease undergoing physiotherapeutic controlat primary care in Chile. Physiother Q 2020;28:48-54. DOI: https://doi.org/10.5114/pq.2020.96236

Schnell K, Weiss CO, Lee T, et al. The prevalence of clinically-relevant comorbid conditions in patients with physician-diagnosed COPD: a cross-sectional study using data from NHANES 1999–2008. BMC Pulm Med 2012;12:26. DOI: https://doi.org/10.1186/1471-2466-12-26

Vella M, Cartwright R, Cardozo L, et al. Prevalence of incontinence and incontinence‐specific quality of life impairment in women with cystic fibrosis. Neurourol Urodyn 2009;28:986-9. DOI: https://doi.org/10.1002/nau.20732

White D, Stiller K, Roney F. The prevalence and severity of symptoms of incontinence in adult cystic fibrosis patients. Physiother Theory Pract 2000;16:35-42. DOI: https://doi.org/10.1080/095939800307593

Arismendi E, Puente-Maestu L, Domingo C, et al. Diagnosed and undiagnosed cough-related stress urinary incontinence in women with refractory or unexplained chronic cough: Its impact on general health status and quality of life. Chron Respir Dis 2024;21:14799731241273751. DOI: https://doi.org/10.1177/14799731241273751

Global Initiative for Chronic Obstructive Lund Disease. GOLD guidelines 2024. Available from: https://goldcopd.org/2024-gold-report/

Wu JM, Vaughan CP, Goode PS, et al. Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol 2014;123:141-8. DOI: https://doi.org/10.1097/AOG.0000000000000057

Kwong PW, Cumming RG, Chan L, et al. Urinary incontinence and quality of life among older community-dwelling Australian men: the CHAMP study. Age Ageing 2010;39:349-54. DOI: https://doi.org/10.1093/ageing/afq025

Nieuwhof-Leppink AJ, Schroeder RPJ, Van De Putte EM, et al. Daytime urinary incontinence in children and adolescents. Lancet Child Adolesc Health 2019;3:492-501. DOI: https://doi.org/10.1016/S2352-4642(19)30113-0

Shang X, Fu Y, Jin X, Wang C, et al. Association of overweight, obesity and risk of urinary incontinence in middle-aged and older women: a meta epidemiology study. Front Endocrinol 2023;14:1220551. DOI: https://doi.org/10.3389/fendo.2023.1220551

Elborn JS, Bell SC. Nutrition and survival in cystic fibrosis. Thorax 1996;51:971-2. DOI: https://doi.org/10.1136/thx.51.10.971

O’Keeffe M, Kelly M, O’Herlihy E, et al. Potentially modifiable determinants of malnutrition in older adults: a systematic review. Clin Nutr 2019;38:2477-98. DOI: https://doi.org/10.1016/j.clnu.2018.12.007

Lian WQ, Li FJ, Huang HX, et al. Constipation and risk of urinary incontinence in women: a meta-analysis. Int Urogynecology J 2019;30:1629-34. DOI: https://doi.org/10.1007/s00192-019-03941-w

Russo E, Caretto M, Giannini A, et al. Management of urinary incontinence in postmenopausal women: An EMAS clinical guide. Maturitas 2021;143:223-30. DOI: https://doi.org/10.1016/j.maturitas.2020.09.005

Bardsley A. An overview of urinary incontinence. Br J Nurs 2016;25:S14-21. DOI: https://doi.org/10.12968/bjon.2016.25.18.S14

Global Initiative for Asthma. GINA guidelines 2023. Available from: https://ginasthma.org/2023-gina-main-report/

Balestri E, Bellofiore A, Mamprin G, et al. La presa in carico fisioterapica del paziente con fibrosi cistica candidato a trapianto bipolmonare. Available from: https://www.sifc.it/wp-content/uploads/2024/04/La-presa-in-carico-fisioterapica-del-paziente-con-Fibrosi-Cistica-candidato-a-trapianto-bipolmonare.pdf. [Material in Italian].

Mamprin G, Cazzarolli C, Leone P, et al. Indicazioni all’esercizio fisico in fibrosi cistica. Available from: https://www.sifc.it/wp-content/uploads/2024/04/Indicazioni-allesercizio-fisico-in-FC-2020.pdf. [Material in Italian].

Bertasi S, Bresci S, Claut L, et al. Fibrosi cistica. I primi anni e l’età della scuola. Available from: https://www.fibrosicisticaricerca.it/wp-content/uploads/2024/11/Libretti-informativi.-Fibrosi-cistica-parliamone-insieme.-I-primi-anni-e-leta-della-scuola.pdf. [Material in Italian].

Bertasi S, Bresci S, Claut L, et al. Fibrosi cistica. L’adolescenza. Available from: https://www.fibrosicisticaricerca.it/wp-content/uploads/2024/11/Libretti-informativi.-Fibrosi-cistica-parliamone-insieme.-Ladolescenza.pdf. [Material in Italian].

Bertasi S, Bresci S, Claut L, et al. Fibrosi cistica. L’età adulta. Available from: https://www.fibrosicisticaricerca.it/wp-content/uploads/2024/11/Libretti-informativi.-Fibrosi-cistica-parliamone-insieme.-Leta-adulta.pdf. [Material in Italian].

Orizzonti FC. Available from: https://www.sifc.it/wp-content/uploads/2020/09/Orizzonti-FC_anno-15_3_2018_sett-dic.pdf.

Cartabellotta A, Furnari ML. Linee guida per la diagnosi e la terapia della fibrosi cistica. Evidence 2018;10:e1000176. [Article in Italian].

Douglas TA, Mulrennan S. Standards of care for cystic fibrosis. Available from: https://www.cysticfibrosis.org.au/wp-content/uploads/2023/08/CFA_Standard-of-Care_Design_Refresh_2023.16.08.23-TD-EDITS.pdf. Accessed: 3/02/2026.

NHS. Clinical guidelines: care of children with cystic fibrosis, 2023. Available from: https://www.rbht.nhs.uk/childrencf.

Southern KW, Addy C, Bell SC, et al. Standards for the care of people with cystic fibrosis; establishing and maintaining health. J Cyst Fibros 2024;23:12-28. DOI: https://doi.org/10.1016/j.jcf.2023.12.002

Haukeland-Parker S, Frisk B, Spruit MA, et al. Treatment of urinary incontinence in women with chronic obstructive pulmonary disease—a randomised controlled study. Trials 2021;22:900. DOI: https://doi.org/10.1186/s13063-021-05816-2

Tozun M, Ayranci U, Unsal A. Prevalence of urinary incontinence among women and its impact on quality of life in a semirural area of western Turkey. Gynecol Obstet Invest 2009;67:241-9. DOI: https://doi.org/10.1159/000209310

How to Cite



“Prevalence of Urinary Incontinence in Patients With Chronic Cough: A Systematic Review”. 2026. Monaldi Archives for Chest Disease 96 (2). https://doi.org/10.4081/monaldi.2026.3767.