Urinary Incontinence Among Female Patients with Lichen Sclerosus: An Updated Systematic Review and Meta-Analysis.

Abstract

Lichen sclerosus (LS) is a chronic inflammatory dermatosis with an autoimmune component, clinically observed to co-occur with pelvic floor disorders, particularly urinary incontinence (UI). However, the strength of this association remains unclear. This study was aimed at the quantitative synthesis of the prevalence of UI in female patients with LS and the risk of UI associated with LS. A systematic search was conducted in PubMed, Web of Science and Medline from inception to 29 December 2025. Observational studies reporting UI data in women with LS were included. Study quality was assessed using Joanna Briggs Institute checklists. A single proportion meta-analysis pooling the prevalence of UI and a comparative meta-analysis calculating risk ratio for UI in LS versus non-LS controls were conducted. Thirteen studies involving 52,002 participants were included. All studies involving 13,296 patients with LS were included for a single-proportion analysis. The pooled prevalence of UI was 0.23 (95% CI 0.12-0.38, I² = 99.3%). The comparative meta-analysis of seven studies (12,370 LS vs 38,487 non-LS participants) showed a 68% increased risk of UI among patients with LS (95% CI 1.28-2.19, I² = 89%). Subgroup analysis indicated that geographic region was a significant source of heterogeneity. Sensitivity analysis confirmed result robustness, although trim-and-fill adjustment suggested a more conservative prevalence estimate. This study suggests that LS in women might be associated with a significantly higher prevalence of UI. Despite considerable heterogeneity, the findings highlight the need for integrated, multidisciplinary care that includes routine urological assessment in the management of LS. Further prospective studies are required.