Objective To systematically evaluate the methodological quality of clinical practice guidelines (CPGs) for female urinary incontinence (UI) worldwide, and to provide evidence-based references for clinical practice and the development of future guidelines.

Methods CNKI, WanFang, VIP, PubMed, Urological and Obstetric-Gynecological Professional Association Platforms, and Clinical Practice Guideline Databases or official websites were electronically searched to collect domestic and overseas publicly released CPGs on female UI published between January 1, 2020 and December 31, 2025. Two independent reviewers appraised the methodological quality of included guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). Inter-rater reliability was assessed using the intraclass correlation coefficient (ICC).

Results A total of 14 CPGs were included, originating from China, the United States, Canada, Ireland, Poland, Europe, and other regions. The ICC values for all AGREE II domains exceeded 0.75. Regarding AGREE II methodological quality, the mean standardized domain scores were 97.02% for scope and purpose, 73.21% for stakeholder involvement, 73.74% for rigor, 98.81% for clarity, 45.39% for applicability, and 92.86% for independence. Overall, 6 guidelines were graded as level A and 8 as level B; 6 high-quality guidelines were ultimately identified.

Conclusion The methodological quality of the CPGs on female UI included in the review needs to be further improved. Future development of high-quality guidelines should strictly adhere to the AGREE II framework to provide more standardized, explicit, and reliable guidance for clinical practice.

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