Association between current or prior hypertensive disorders of pregnancy and urge urinary incontinence or overactive bladder: a scoping review protocol

This scoping review aims to map, characterize, and synthesize the available evidence regarding the association between hypertensive disorders of pregnancy (HDP), primarily preeclampsia (PE) and gestational hypertension (GH), diagnosed either during the index pregnancy or documented as a prior obstetric history, and the presentation or subsequent development of urge urinary incontinence (UUI) or overactive bladder (OAB). HDP are characterized by profound multisystemic derangements, notably marked by systemic endothelial dysfunction, chronic oxidative stress, and persistent dysregulation of the renin-angiotensin system (RAS). In PE, a generalized hyperresponsiveness to Angiotensin II extends beyond the systemic vasculature. Functional Angiotensin II receptors are widely distributed throughout the lower urinary tract, particularly within the detrusor muscle and urothelium. Concurrently, systemic microvascular impairment and ischemic insults, both hallmarks of HDP, mirror the pathophysiological cascades implicated in detrusor overactivity and bladder dysfunction, potentially manifesting acutely during pregnancy or persisting into the puerperium and long term. Grounded in the Joanna Briggs Institute (JBI) methodology for scoping reviews and reported according to PRISMA-ScR guidelines, this study will map the underlying biological rationales and empirical findings across the pregnancy–postpartum continuum. Specifically, it will evaluate whether acute and sustained vascular or neurohumoral disruptions associated with HDP correlate with storage lower urinary tract symptoms during pregnancy and an increased medium- to long-term risk of UUI and OAB. Furthermore, this review will identify critical evidence gaps and outline clinical priorities to guide future prospective research.