Recurrent Urinary Tract Infection among Women with Pelvic Floor Muscle Dysfunction: Systematic Review and Meta-Analysis

Abstract

Background and Objectives: Recurrent urinary tract infections (RUTIs) represent a major health burden among women, particularly those with pelvic floor muscle dysfunction (PFMD) and pelvic organ prolapse (POP). This systematic review and meta-analysis aimed to synthesize evidence on the incidence, prevalence, and risk factors associated with RUTIs in this population. Methods: A systematic search of PubMed, Scopus, Web of Science, EMBASE, and CINAHL (2000-2025) identified fifteen studies meeting inclusion criteria. Eligible studies evaluated women with PFMD and/or POP, reporting on RUTI incidence, prevalence, or associated risk factors. Data extraction followed standardized protocols, with independent review and cross-verification. Statistical analyses included pooled prevalence estimates, subgroup and sensitivity analyses, and evaluation of publication bias. Results: The prevalence of PFMD ranged from 19% to 100%. Significant risk factors for RUTIs included urinary incontinence, cystocele, and elevated postvoid residual urine. Age was a modifying factor, with higher risk in women over 50 years. POP and procidentia uteri were associated with increased UTI risk in some studies, though findings varied. Pessary use was identified as a potential protective factor. Heterogeneity in definitions and methodologies across studies was noted. Conclusions: This meta-analysis underscores the complex interplay of PFMD, prolapse, and RUTIs. Key risk factors highlight the importance of individualized patient assessment and tailored interventions. Findings suggest the need for standardized diagnostic criteria and further high-quality studies to strengthen evidence-based management strategies.