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Meta-Analysis
©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Urol. Feb 12, 2026; 15(1): 115330
Published online Feb 12, 2026. doi: 10.5410/wjcu.v15.i1.115330
Double incontinence among women globally: A systematic review and meta-analysis
John Katongole, Prosper Akankwasa, Esther Namutosi, Theoneste Hakizimana, Idrissa A Suleiman, Jackson Kakooza, Catherine R Lewis, Emmanuel Okurut
John Katongole, Prosper Akankwasa, Esther Namutosi, Theoneste Hakizimana, Idrissa A Suleiman, Emmanuel Okurut, Department of Obstetrics and Gynecology, Kampala International University Western Campus, Ishaka Bushenyi, Uganda
Jackson Kakooza, Department of Surgery, Kampala International University Western Campus, Ishaka Bushenyi, Uganda
Catherine R Lewis, Department of Surgery, St. Joseph’s Kitovu Hospital, Masaka, Uganda
Author contributions: Katongole J, Akankwasa P, Namutosi E, Hakizimana T, Suleiman IA, Kakooza J, and Okurut E designed the research study; Katongole J, Akankwasa P, Namutosi E, Hakizimana T, Suleiman IA, and Kakooza J performed the methodology; Katongole J, Akankwasa P, Namutosi E, Hakizimana T, Suleiman IA, and Kakooza J collected the data; Katongole J, Akankwasa P, Namutosi E, Hakizimana T, Suleiman IA, Kakooza J, Lewis CR, and Okurut E performed data analysis; Katongole J, Akankwasa P, Namutosi E, Hakizimana T, Suleiman IA, and Kakooza J wrote the original draft; Katongole J, Kakooza J, Lewis CR, and Okurut Emmanuel reviewed and edited the final manuscript; Lewis CR and Okurut E supervised and validated the research; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Emmanuel Okurut, Chief Physician, Consultant, Department of Obstetrics and Gynecology, Kampala International University Western Campus, F46V + MW2, Ishaka Bushenyi, Uganda. okurutemmanuel@kiu.ac.ug
Received: October 15, 2025
Revised: November 16, 2025
Accepted: January 12, 2026
Published online: February 12, 2026
Processing time: 119 Days and 13.5 Hours
Abstract
BACKGROUND

Double incontinence (DI), defined as the co-occurrence of urinary and anal incontinence, is a major cause of morbidity.

AIM

To estimate the pooled prevalence of DI among women globally.

METHODS

A systematic review and meta-analysis was conducted following PRISMA guidelines, searching PubMed, Scopus, Web of Science, and Lens.org for observational studies from January 2010 to May 2025. Eligible studies reported DI prevalence in women. Titles and abstracts were screened using Rayyan, and data were pooled using a random-effects model in Jamovi v2.6.44. Heterogeneity was assessed via I2 and Q statistics, and publication bias was evaluated using Egger’s regression and funnel plots.

RESULTS

Ten studies (n = 76009 women) from seven countries spanning four World Health Organization regions were included. The pooled prevalence of DI was 8.66% [95% confidence interval (CI): 7.14%-10.63%], with moderate heterogeneity (I2 = 32.7%, 95%CI: 0.0%-62.8%; Q = 13.396, P = 0.145; Tau2 = 0.0374, 95%CI: 0.000-0.152). Sensitivity analyses confirmed robustness, with leave-one-out estimates ranging from 8.31% to 9.25%. Meta-regression explained only 23.8% of heterogeneity, indicating measurement variability as the primary source. No significant publication bias was detected across multiple methods (Egger’s P = 0.721; Begg’s P = 1.000; trim-and-fill: Zero imputed studies; Fail-Safe n = 2554). Cumulative meta-analysis showed temporal stability (2009-2020).

CONCLUSION

DI affects approximately 8.7% of women in studied populations (predominantly middle- and high-income countries), representing a significant public health priority. This pooled international estimate is most applicable to urban/peri-urban women in settings with healthcare access. Critical geographic gaps (Sub-Saharan Africa, South-East Asia) and absence of low-income country representation limit global generalizability. Standardized DI definitions and targeted research in underrepresented regions are essential to achieve truly comprehensive global estimation and inform equitable, evidence-based interventions.

Keywords: Double incontinence; Urinary incontinence; Anal incontinence; Women; Meta-analysis; Prevalence

Core Tip: The concurrent presence of urinary incontinence and anal incontinence, or double incontinence, causes significant morbidity in women with a substantial impact on quality of life. Its inconsistencies in diagnosis and stigmatization lead to underreporting. Double incontinence affects approximately 9% of diverse populations globally, highlighting its public health significance. Future research is needed in underrepresented regions in order to establish a truly comprehensive global estimation and to inform evidence-based interventions.