More activity links to less incontinence
Higher physical activity was associated with lower odds of urinary incontinence in adult women, while sedentary behavior showed no clear link.
*Systematic review and meta-analysis of observational studies; Level 2a (OCEBM).

Citation

Sánchez-Martín C, Vila-Maldonado S, Leal-Martín J, et al. Association of physical activity and sedentary behavior with urinary incontinence in adult women: a systematic review and meta-analysis of observational studies. American Journal of Obstetrics & Gynecology. 2026; (May):1286–1305. doi:10.1016/j.ajog.2025.11.024.

Background

Urinary incontinence is common in women and can reduce quality of life. Lifestyle factors such as physical activity may affect risk, but prior results have been mixed and often limited to specific subgroups.

Patients

Adult women (≥18 years) in observational studies; excluded pregnant/postpartum women, athletes, women with major pelvic surgery, neurologic disorders, or certain cancers.

Intervention

Higher physical activity (definitions varied across studies).

Control

Lower physical activity.

Outcome

Urinary incontinence prevalence or new-onset urinary incontinence (overall and by type: stress, urgency, mixed).

Follow-up Period

Cross-sectional or 2 to 11.5 years (longitudinal studies).

Results

Forty-three studies (295,513 women) were included; 25 studies (166,744 women) were pooled in meta-analyses. Study quality was generally fair.
Analysis Outcome Odds ratio (95% confidence interval)
Cross-sectional (highest vs lowest activity) Any urinary incontinence (primary) 0.70 (0.60–0.82)
Cross-sectional (highest vs lowest activity) Mixed urinary incontinence 0.57 (0.40–0.80)
Longitudinal (highest vs lowest activity) New-onset any urinary incontinence (primary) 0.82 (0.75–0.89)
Longitudinal (highest vs lowest activity) New-onset stress urinary incontinence 0.77 (0.65–0.92)
Longitudinal (highest vs lowest activity) New-onset urgency urinary incontinence 0.69 (0.48–0.99)
Longitudinal (highest vs lowest activity) New-onset mixed urinary incontinence 0.66 (0.48–0.92)

Limitations

Because included studies were observational, the findings cannot prove that physical activity prevents urinary incontinence. Most studies used self-reported activity and symptoms, and activity definitions varied. Sedentary behavior evidence was sparse and mostly cross-sectional. Residual confounding (for example, differences in weight, childbirth history, or health status) is likely.

Funding

Spanish public research funders and European Union funds; funders had no study role.

Clinical Application

Encourage regular physical activity as part of incontinence prevention counseling; do not assume reducing sedentary time alone lowers risk. Consider other risk factors and patient comfort.