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Risk factors and quality of life in women with urinary incontinence in Kazakhstan
The first large multicentre study of urinary incontinence in women in Kazakhstan. It showed which obstetric and metabolic factors are linked to the condition and how different types of incontinence affect quality of life.
Ryspayeva Zh, Khismetova Z, Serikova-Esengeldina D, et al. Risk Factors and Quality of Life in Women with Urinary Incontinence in Kazakhstan: A Multicenter Case–Control Study. Int J Environ Res Public Health. 2026;23(7):893. doi:10.3390/ijerph23070893
Why the study was done
Urinary incontinence is a common women's health problem that affects physical, psychological and social well-being. Yet evidence from Central Asia is scarce: most studies come from Europe, North America and East Asia. The authors set out to find which factors are linked to incontinence in women in Kazakhstan and how much it reduces quality of life.
How it was done
- Design: multicentre, age-matched case–control study.
- Period: February–May 2025.
- Participants: 2,061 women from healthcare facilities in Kazakhstan.
- Data collection: a structured questionnaire — sociodemographic and obstetric data, lifestyle, comorbidities, symptoms.
- Quality of life: Kazakh and Russian versions of the I-QOL (Incontinence Quality of Life) questionnaire.
- Analysis: multivariable logistic regression.
Main results
Among women with incontinence, stress incontinence was the most common — over half of cases. Urinary incontinence was independently associated with:
- multiple birth — odds ratio 2.26;
- body mass index of 25 kg/m² or more — 2.08;
- giving birth to a large baby (macrosomia) — 1.83;
- vaginal delivery — 1.48.
Quality of life was most impaired in women with urgency incontinence: their total I-QOL score was the lowest (median 36.4).
The authors' conclusions
Urinary incontinence in women in Kazakhstan is linked mainly to obstetric and metabolic factors. The authors recommend:
- including weight management in prevention programmes;
- counselling women about the pelvic floor during pregnancy;
- postnatal follow-up and early assessment of pelvic floor function;
- developing screening, reducing stigma and creating culturally appropriate support programmes.
How to interpret these data
A case–control design compares women with and without incontinence. It's good at showing which factors are associated with the condition but doesn't prove that a factor causes it. Nor does it tell us how common incontinence is among all women in the country: the 33.3% figure refers to the sample, not the population.
The data were also collected by questionnaire in healthcare facilities, so recall may be imprecise and participants may differ from women who don't see doctors. These limitations are typical of this type of study.
What this means in practice
The strongest associated factors are multiple birth and excess weight — and weight can be changed. This supports the case that prevention works: weight management, pelvic floor training during pregnancy and after birth, and seeking help early. Practical advice is in Prevention and Pregnancy, birth and the pelvic floor.