Keywords
Sensors
Adult Diapers
Wearable Electronic Devices
Nursing Care
Systematic Review
How to Cite
Abstract
Background. Urinary incontinence (UI) is prevalent in older populations. UI is associated with reduced quality of life, skin complications, and increased caregiver burden. Sensor-based UI technologies have been introduced to support timely and individualized care beyond routine check-and-change practices, but their effectiveness remains unclear.
Objectives: To examine the sensor-based technologies used in UI care and to synthesize evidence regarding their effects on patient and caregiver outcomes.
Methods. A search was conducted in December 2025 using five databases (PubMed, CINAHL, EMBASE, the Cochrane Library, and IEEE Xplore) in accordance with the PRISMA guidelines. Search terms included “urinary incontinence,” “smart diaper,” “smart pad,” “sensor,” “wearable sensor,” and “continence monitoring,” combined using Boolean operators (AND, OR) and controlled vocabulary (e.g., MeSH, EMTREE). Studies included if they applied sensor-based UI technologies embedded in pads or diapers, and reported clinical outcomes related to UI care.
Results. Eight studies were included. Sensor-based UI technologies ranged from systems that detected voiding, leakage, saturation, or urine volume and provided alerts to advanced systems using sensor-derived data for voiding pattern analysis and individualized care planning. Technical performance and care-process outcomes were mixed, although some studies reported improvements in pad checking, leakage, absorbent product use, and adherence to individualized care plans. Patient outcomes showed limited improvements, with some benefits in skin condition, continence-related outcomes, and sleep interruptions. Caregiver outcomes generally indicated favorable usability, perceived usefulness, and support for decision-making, although controlled studies did not demonstrate improvements in caregiver burden, work engagement, or organizational headroom. Evidence regarding informal caregivers remained limited.
Conclusion. Sensor-based UI technologies may support more timely and individualized UI care by improving care processes and caregiver decision-making. Given the important role of informal caregivers in UI care, future research should evaluate the effects on informal caregiver outcomes.
References
Agholme, F., Lamparski, A., & Radziszewski, P. (2023). POWER: An Open, Single-Arm, Post-Market Clinical Trial Using the TENA SmartCare Change Indicator in a Home Environment. Archives of Medical Science, 19(1), 270-273. https://doi.org/10.5114/aoms/158568
Akpinar, N. B., Unal, N., & Akpinar, C. (2023). Urinary Incontinence in Older Adults: Impact on Caregiver Burden. Journal of Gerontological Nursing, 49(4), 39-46. https://doi.org/10.3928/00989134-20230310-01
Barker, T. H., Habibi, N., Aromataris, E., Stone, J. C., Leonardi-Bee, J., Sears, K., Hasanoff, S., Klugar, M., Tufanaru, C., Moola, S., & Munn, Z. (2024). The Revised JBI Critical Appraisal Tool for the Assessment of Risk of Bias for Quasi-Experimental Studies. JBI Evidence Synthesis, 22(3), 378-388. https://doi.org/10.11124/jbies-23-00268
Barker, T. H., Stone, J. C., Sears, K., Klugar, M., Tufanaru, C., Leonardi-Bee, J., Aromataris, E., & Munn, Z. (2023). The Revised JBI Critical Appraisal Tool for the Assessment of Risk of Bias for Randomized Controlled Trials. JBI Evidence Synthesis, 21(3), 494-506. https://doi.org/10.11124/jbies-22-00430
Bishop, C., Rodriguez-Cairoli, F., Hagens, A., Bermudez, M. A., Kerrebroeck, P. V., & Collen, S. (2025). Prevalence, Socioeconomic, and Environmental Costs of Urinary Incontinence in the European Union. European Urology, 88(2), 157-166. https://doi.org/10.1016/j.eururo.2025.05.025
Cho, J. H., Choi, J. Y., Kim, N. H., Lim, Y., Ohn, J. H., Kim, E. S., Ryu, J., Kim, J., Kim, Y., Kim, S. W., & Kim, K. I. (2021). A Smart Diaper System Using Bluetooth and Smartphones to Automatically Detect Urination and Volume of Voiding: Prospective Observational Pilot Study in an Acute Care Hospital. Journal of Medical Internet Research, 23(7), e29979. https://doi.org/10.2196/29979
Department of Veterans’ Affairs. (2020). Continence with Care: A Resource Reference for Personal Care Workers. https://www.dva.gov.au/sites/default/files/files/providers/cn/dva-pcv-resource-continence-with-care-may2020.pdf
Freeman, S., Otalvaro Zapata, S., & Sargent, M. J. (2025). Enhancing Quality of Resident Care and Staff Efficiency Through Implementation of Sensors in the Long-Term Care Setting: A Multi-Site Mixed-Methods Study. Sensors, 25(21), 6795. https://doi.org/10.3390/s25216795
Gröning, R., Schöttler, E., Michalski, S., & Schmidt, S. (2024). Scoping Review: Technology-Based Nursing Interventions for Urinary Incontinence for Individuals 65 Years and Older. International Journal of Urological Nursing, 18(2), e12409. https://doi.org/10.1111/ijun.12409
Haylen, B. T., de Ridder, D., Freeman, R. M., Swift, S. E., Berghmans, B., Lee, J., Monga, A., Petri, E., Rizk, D. E., Sand, P. K., & Schaer, G. N. (2010). An International Urogynecological Association (IUGA)/International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Floor Dysfunction. International Urogynecology Journal, 21(1), 5-26. https://doi.org/10.1007/s00192-009-0976-9
Jeong, G., & Park, S. (2019). Review of Urinary Continence Care Products Using Sensor Technology to Improve Effectiveness. Proceedings of the Institution of Mechanical Engineers, 233(1), 91-99. https://doi.org/10.1177/0954411918794989
Kim, J. H., Lee, U. C., Jeong, B. H., Kang, B. U., Shim, S. R., & Jeong, I. G. (2024). Accuracy of a Smart Diaper System for Nursing Home Residents for Automatically Detecting Voided Volume: Instrument Validation Study. JMIR Formative Research, 8, e58583. https://doi.org/10.2196/58583
Kottner, J., & Dissemond, J. (2025). Incontinence-Associated Dermatitis in Older Adults: A Critical Review of Risk Factors, Prevention and Management. Drugs & Aging, 42(8), 745-754. https://doi.org/10.1007/s40266-025-01227-z
Long, A., Edwards, J., Worthington, J., Cotterill, N., Weir, I., Drake, M. J., & van den Heuvel, E. (2015). Clinical Evaluation of a Prototype Underwear Designed to Detect Urine Leakage From Continence Pads. Journal of Wound, Ostomy and Continence Nursing, 42(6), 632-639. https://doi.org/10.1097/won.0000000000000178
Marcu, I., Powell, A., & Hickman, L. C. (2024). Evaluation and Management of Urinary Incontinence in Nursing Home Residents: Unique Considerations for an At-Risk Population. Gynecology and Pelvic Medicine, 7. https://doi.org/10.21037/gpm-24-5
Milsom, I., & Gyhagen, M. (2019). The Prevalence of Urinary Incontinence. Climacteric, 22(3), 217-222. https://doi.org/10.1080/13697137.2018.1543263.
Nambiar, A. K., Arlandis, S., Bø, K., Cobussen-Boekhorst, H., Costantini, E., de Heide, M., Farag, F., Groen, J., Karavitakis, M., Lapitan, M. C., Manso, M., Arteaga, S. M., Riogh, A. N. A., O'Connor, E., Omar, M. I., Peyronnet, B., Phé, V., Sakalis, V. I., Sihra, N.,…Harding, C. K. (2022). European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 1: Diagnostics, Overactive Bladder, Stress Urinary Incontinence, and Mixed Urinary Incontinence. European Urology, 82(1), 49-59. https://doi.org/10.1016/j.eururo.2022.01.045
Newman, D., Specht, J., & Eason, S. (2019). Prompted Voiding for Persons with Urinary Incontinence. Journal of Gerontological Nursing, 45(2), 14-26. https://doi.org/10.3928/00989134-20190111-03.
Nikoletti, S., Young, J., & King, M. (2004). Evaluation of an Electronic Monitoring Device for Urinary Incontinence in Elderly Patients in an Acute Care Setting. Journal of Wound Ostomy and Continence Nursing, 31(3), 138-149. https://doi.org/10.1097/00152192-200405000-00008.
Noyori, S. S., Nakagami, G., & Sanada, H. (2022). Non-invasive Urine Volume Estimation in the Bladder by Electrical Impedance-Based Methods: A Review. Medical Engineering & Physics, 101, 103748. https://doi.org/10.1016/j.medengphy.2021.103748
Omotunde, M., & Wagg, A. (2023). Technological Solutions for Urinary Continence Care Delivery for Older Adults: A Scoping Review. Journal of Wound, Ostomy and Continence Nursing, 50(3), 227-234. https://doi.org/10.1097/won.0000000000000965
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S.,…Moher, D. (2021). The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Patel, U. J., Godecker, A. L., Giles, D. L., & Brown, H. W. (2022). Updated Prevalence of Urinary Incontinence in Women: 2015-2018 National Population-Based Survey Data. Female Pelvic Medicine and Reconstructive Surgery, 28(4), 181-187. https://doi.org/10.1097/spv.0000000000001127
Pizzol, D., Demurtas, J., Celotto, S., Maggi, S., Smith, L., Angiolelli, G., Trott, M., Yang, L., & Veronese, N. (2021). Urinary Incontinence and Quality of Life: A Systematic Review and Meta-Analysis. Aging clinical and experimental research, 33(1), 25-35. https://doi.org/10.1007/s40520-020-01712-y
Rajabali, S. N., Hunter, K. F., Asaana, P., McCreary, M. L., Nazari, S., & Wagg, A. S. (2023). Effectiveness of a Smart Urinary Continence Care Assessment System for Nursing Home Residents: A Quasi-Experimental, Sequential Quantitative-Qualitative Methods Trial. Journal of Wound, Ostomy and Continence Nursing, 50(1), 48-56. https://doi.org/10.1097/won.0000000000000937
Skotnes, L. H., Hellzen, O., & Kuhry, E. (2013). Perceptions and barriers that influence the ability to provide appropriate incontinence care in nursing home residents: Statements from nursing staff. Open Journal of Nursing, 3(6), 437-444. https://doi.org/10.4236/ojn.2013.36059
Soysal, P., Veronese, N., Ippoliti, S., Pizzol, D., Carrie, A. M., Stefanescu, S., López-Sánchez, G. F., Barnett, Y., Butler, L., & Koyanagi, A. (2023). The Impact of Urinary Incontinence on Multiple Health Outcomes: An Umbrella Review of Meta-Analysis of Observational Studies. Aging Clinical and Experimental Research, 35(3), 479-495. https://doi.org/10.1007/s40520-022-02336-0
van Cooten, V. J. C., Gielissen, M. F. M., den Hollander, W., van Mastrigt, G. A. P. G., Smeets, O., Bongers, I. M. B., & Boon, B. (2025). Effectiveness of Smart Continence Care for People With Profound Intellectual and Multiple Disabilities: Cluster Randomized Trial. Journal of Medical Internet Research, 27. https://doi.org/10.2196/66389
van den Bosch, F., van Leuteren, P., Tobisch, S., & Duijvesz, D. (2025). A bladder sensor for adults with urinary incontinence. Neurourology and Urodynamics, 44(4), 795-803. https://doi.org/10.1002/nau.70009
Wagg, A., Agholme, F., Schwiegel, H., Huige, N., & Hayder-Beichel, D. (2025). A Post-Market, Cluster Randomised Controlled Trial of the Effect of the TENA SmartCare Change Indicator on Continence Care Efficiency and Skin Health in Nursing Homes. Age and Ageing, 54(8), afaf236. https://doi.org/10.1093/ageing/afaf236
Walzer, S., Armbruster, C., Mahler, S., Farin-Glattacker, E., & Kunze, C. (2025). Factors Influencing the Implementation and Adoption of Digital Nursing Technologies: Systematic Umbrella Review. Journal of Medical Internet Research, 27, e64616. https://doi.org/10.2196/64616
Weinstein, M. M., Dunivan, G., Guaderrama, N. M., & Richter, H. E. (2022). Digital Therapeutic Device for Urinary Incontinence: A Randomized Controlled Trial. Obstetrics & Gynecology, 139(4), 606-615. https://doi.org/10.1097/AOG.0000000000004725
Yu, P., Hailey, D., Fleming, R., & Traynor, V. (2014). An Exploration of the Effects of Introducing a Telemonitoring System for Continence Assessment in a Nursing Home. Journal of Clinical Nursing, 23(21-22), 3069-3076. https://doi.org/10.1111/jocn.12538
Zhu, Y., Cai, W., Liu, S., Zhang, D., Luo, D., Huang, S., Shi, W., Yang, L., Zhang, S., & Fang, H. (2025). Mobile App–Based Self-Management of Urinary Incontinence in Pregnant Women: Multicenter Pragmatic Randomized Controlled Trial. Journal of Medical Internet Research, 27, e72883. https://doi.org/10.2196/72883
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 JuHee Lee, Kiyeon Kim, Deokhyun Lee