Mapping the Conversation: A Network Analysis of World Continence Week on Twitter/X.

Mapping the Conversation: A Network Analysis of World Continence Week on Twitter/X - PMC Skip to main content An official website of the United States government Here's how you know Here's how you know Search Log in Primary site navigation Search Log in Search PMC Full-Text Archive Search in PMC Journal List User Guide As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice Int Urogynecol J . 2025 Nov 28;37(5):1413–1421. doi: 10.1007/s00192-025-06443-0 Mapping the Conversation: A Network Analysis of World Continence Week on Twitter/X Esra Bilir 1, 2, 10, 12, 13 , Wasim Ahmed 3 , Josep Vidal-Alaball 4, 5, 6 , Marina Moreno Martinez 4, 6, 7, 11, ✉ , Boris Gabriel 2 , Kayal Gasimli 8, 14 , Bettina Blau-Schneider 2, 9 Author information Article notes Copyright and License information 1 Department of Gynecologic Oncology, Koç University School of Medicine, Istanbul, Türkiye 2 Department of Obstetrics and Gynecology, St. Josefs-Hospital Wiesbaden Academic Teaching Hospital of Johannes Gutenberg University of Mainz, Wiesbaden, Hessen Germany 3 Hull University Business School, Hull, England 4 Research and Innovation Unit, Gerència d’Atenció Primària I a La Comunitat de La Catalunya Central, Institut Català de La Salut, Manresa, Spain 5 Department of Medicine, Faculty of Medicine, University of Vic-Central University of Catalonia, Vic, Spain 6 Intelligence for Primary Care Research Group, Fundació Institut Universitari Per a La Recerca a L’Atenció Primària de Salut Jordi Gol I Gurina, Manresa, Spain 7 Faculty of Health Sciences, University of Manresa, Manresa, Spain 8 Department of Obstetrics and Gynecology, University Hospital of Frankfurt, Theodor-Stern-Kai 7, 60596 Frankfurt Am Main, Germany 9 Department of Obstetrics and Gynecology, University Hospital of Wuerzburg, Josef-Schneider-Strasse 4, 97080 Würzburg, Germany 10 Department of Gynecology and Obstetrics, Johann Wolfgang Goethe University, Frankfurt, Germany 11 CAP Bages, Carrer de Soler I March, 6, 08242 Manresa, Barcelona, Spain 12 Department of Gynecology and Obstetrics, University Medical Center Göttingen, Göttingen, Germany 13 Department of Gynecology and Obstretrics, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany 14 Department of Gynecology and Obstretrics, Hospital zum Heiligen Geist Frankfurt, Frankfurt am Main, Germany Handling Editor: Tony Bazi Editor in Chief: Maria A. Bortolini ✉ Corresponding author. Received 2025 Jun 27; Accepted 2025 Oct 29; Issue date 2026. © The Author(s) 2025 Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ . PMC Copyright notice PMCID: PMC13226395  PMID: 41313436 Abstract Introduction and Hypothesis Female urinary incontinence affects over 60% of women globally. Despite its prevalence, social stigma limits public discussions. World Continence Week (WCW) June 17–23, 2024, aimed to increase awareness using coordinated social media campaigns. We aimed to evaluate the impact of official hashtags and campaigns during WCW on public engagement on Twitter/X. Methods We searched the posts containing official WCW hashtags (#CommitmentToCollaborationIncontinenceCare, #WCW2024, #ContinenceMatters, and #SupportIncontinence) and additional hashtags (#incontinence, #femaleincontinence, and #UrinaryIncontinence) collected from June 10 to June 30, 2024, covering WCW, using NodeXL Pro drawing upon social network analysis. User interactions, geographic distribution, hashtag usage, and key influencers were identified in our analysis. Our study drew upon the Clauset–Newman–Moore clustering and betweenness centrality algorithms. Results Our analysis included 20,000 posts and accumulated 861,591 interactions. The network included 317 users, with medical organizations, healthcare professionals, and patient groups dominating the conversation. Official WCW accounts had the highest influence, while active news outlets amplified reach. Shared URLs were from reputable medical institutions. The use of official hashtags showed widespread alignment on campaign themes. Conclusions WCW 2024’s social media strategy effectively raised incontinence awareness, highlighting the importance of coordinated digital campaigns for destigmatizing women’s health issues. Keywords: Network analysis, World Continence Week, Incontinence, Social media, Twitter Introduction A population-based study involving more than 5000 women reassessed the prevalence of female incontinence, finding that nearly 62% experienced it at varying degrees [ 1 ]. Incontinence results from a variety of risk factors, such as multiple sclerosis, diabetes, and Parkinson’s disease, and is often accompanied by pelvic organ prolapse (POP) with varying levels of severity. Therefore, it is crucial to highlight the importance of early intervention, particularly through conservative and nonsurgical treatment methods to avoid multiple complex and unnecessary interventions. It is crucial to accelerate public conversations about incontinence to raise awareness. However, similar to many other gynecological issues, female incontinence continues to be a taboo subject in society. For instance, the hashtag #VaginalCancer on Instagram was temporarily blocked simply because it contained the word “vagina” [ 2 ]. However, thanks to the persistent efforts of patient advocacy groups, the hashtag was eventually activated [ 2 ]. The use of social media has grown significantly over the years among both patients and healthcare professionals. A multicenter survey conducted in the United States found that among 282 women attending clinical visits at female pelvic medicine and reconstructive surgery fellowship programs, 75.0% reported frequent internet use, and 74.1% had active social media accounts [ 3 ]. The introduction of gynecologic oncology, specific hashtags during virtual congresses held throughout the COVID-19 pandemic greatly enhanced the quality and relevance of discussions among gynecologic oncologists, effectively directing the focus toward key topics in the field [ 4 , 5 ]. During World Gynecologic Oncology Day, To effectively raise, campaigns on X (formerly known as Twitter) were reported to be successful when centered around a single and easy hashtag and synchronized through strategically timed posts by influential accounts, especially [ 6 ]. Twitter, now called X, reported as a strong social media platform for scientific communication among gynecologic oncologists, especially by dedicated social media ambassadors and strategic collaborations with prominent professional networks [ 7 ]. A study observed that since the creation of specialized Social Media Committees within the Annals of Surgical Oncology, the journal articles have experienced a significant increase in engagement on Twitter/X [ 8 ]. Furthermore, Instagram has be reported a powerful tool for raising awareness about ovarian cancer, endometrial cancer, vaginal cancer, vulva cancer, cervical cancer, and human papillomavirus vaccination [ 9 – 15 ]. Urinary incontinence (UI) remains an under-recognized and under-reported condition within healthcare. Despite its significant impact on quality of life, only about one-third of affected individuals seek medical treatment, largely due to persistent barriers such as stigma, misconceptions, and limited awareness. Therefore, social media plays a crucial role in addressing misinformation and challenging prevailing taboos. A comprehensive analysis of Twitter activity related to the hashtags #Incontinence, #InterstitialCystitis, #OAB, #FPMRS, #BPH, and #UroBPH by urologists identified a total of 191,383 tweets from 54,094 users between 2015 and 2018 [ 16 ]. The authors concluded that discussions surrounding #Incontinence remain underrepresented, particularly when contrasted with the high prevalence of urinary incontinence in the general population [ 16 ]. June 17–23 is celebrated as World Continence Week (WCW) [ 17 ]. The official hashtags for World Continence Week (WCW) 2024 are: #CommitmentToCollaborationIncontinenceCare, #WCW2024, #ContinenceMatters, and #SupportIncontinence [ 17 ]. WCW is a global awareness program organized annually by the World Federation of Incontinence and Pelvic Problems (WFIPP), with the endorsement and support of leading organizations including the International Continence Society (ICS), the European Association of Urology (EAU), and the Ibero-American Society of Neurourology and Urogynaecology (SINUG) [ 17 ]. This campaign aims to spotlight the challenges faced by individuals living with bladder and bowel disorders, chronic pelvic pain, and related conditions that significantly affect the well-being of patients, their families, and caregivers [ 17 ]. For 2024, the central themes focus on Shared Decision-Making, the intersection of Incontinence and Mental Health, and a strong Commitment to Collaboration in Continence Care, collectively referred as the 4 C’s Project [ 17 ]. Currently, there is no study in the literature that has evaluated the impact of WCW awareness on social media platforms. In this study, our goal is to analyze Twitter/X activity related to incontinence during WCW using social network analysis. Additionally, we examine geographic distribution patterns and emerging trends. Furthermore, our objective included to assess the impact of official social media campaigns in raising public awareness about incontinence. Materials and Methods In our study, alongside the official hashtags for WCW 2024 (#CommitmentToCollaborationIncontinenceCare, #WCW2024, #ContinenceMatters, and #SupportIncontinence), we also incorporated additional relevant hashtags such as #incontinence, #femaleincontinence, and #UrinaryIncontinence to broaden the scope and engagement of our analysis. Data Collection & Analysis The data set used in our study consists of 20,000 posts (formerly tweets) containing all these hashtags collected between June 10 at 00:00:00 and June 30 at 23:55:59 2024. Our data set included tweet replies, mentions, retweets, and quoted tweets featuring these hashtags. The network was obtained from Twitter on Wednesday, February 19, 2025 at 15:12 UTC. The data were retrieved using NodeXL Pro (Social Media Research Foundation) [ 18 ]. The network graph was generated using the Harel–Koren fast multiscale layout algorithm [ 19 ]. A network analysis was conducted, and the nodes were clustered using the Clauset–Newman–Moore algorithm to identify community structures [ 20 ]. The selected hashtags and time frame correspond to a period of World Continence Week, including conversations related to the WCW2024 conference. In our study, we used Twitter’s Academic Track Application Programming Interface (API) to retrieve tweets, employing the “academictwitteR” library for data collection. The extracted tweet IDs were then processed in NodeXL. Data retrieval was performed on a Microsoft Windows 10 computer using Microsoft Excel 2016 with the professional version of NodeXL (release code +1.0.1.428+). Twitter’s search API was used to collect tweets, and URLs within tweets were automatically expanded within NodeXL for better analysis. Following the generation of the network analysis graph, we identified the top five most active users (“top 5 tweeters”) and compiled their key profile details into a summary table. This included each user’s rank, X (formerly Twitter) handle, biography, total number of network interactions (referred to as the Entire Graph Count), listed location, and follower count, all recorded as of the data extraction date. The rank reflects the user’s relative position (1st to 5th) based on their engagement within the network. The handle indicates the username on X at the time of analysis. The Entire Graph Count captures the total number of interactions or connections that the user had across the network. The location refers to the country or city stated in their profile, when available. The follower count represents the number of followers the user had on the date of data collection. A comprehensive analysis was conducted to highlight the top five most influential users in the network. For each user, the following details were included: ranking, X (formerly Twitter) handle, profile biography, betweenness centrality, and listed location. All data were recorded on the date of extraction. The rankings indicate each user’s relative influence or engagement within the network, from first to fifth place. The handle reflects the username on X at the time of data collection, while the biography offers a brief personal or professional description from their profile. Betweenness centrality measures how frequently a user appears on the shortest communication paths between others, reflecting their role as a key connector. Location refers to the country or city stated in the user’s profile, when available. The top five tweeters simply refer to those users who have contributed the most tweets overall. Whereas the top influential users (ranked by betweenness centrality) look at the strategic position of the users and their role within the flow of information. In addition, we performed a focused analysis of the five most widely shared URLs within each port, documenting their rank, title, associated institution or domain, the URL, and the total number of shares. We also analyzed the most frequently used hashtags in tweets from the five most active groups. These hashtags were classified into four main categories, and we reported how often each category appeared across all posts. Definitions A hashtag is a tag preceded by the symbol “#” that functions as a keyword or phrase to categorize and index digital content across social media platforms. In social network analysis, a network is conceptualized as a set of socially relevant nodes connected by one or more relations. Graphical illustrations are employed to reveal structural patterns, while mathematical and computational models are used to quantify and explain these relationships. Nodes can represent individuals, X users, hashtags, or other entities within the network, with edges denoting the connections or interactions between them. In the present study, nodes included both X accounts (authors and retweeters) and hashtags, enabling an exploration of the relationships between these elements. Edges defined the associations between nodes, such as interactions or shared activity. Betweenness centrality, a key network metric, was used to detect the influence of nodes on information flow by measuring how often a node appears on the shortest path between others, thereby identifying nodes that serve as bridges within the network. Additionally, “mentions” were defined as posts containing another user’s handle anywhere in the text, representing a direct form of interaction. Results During the WCW in 2024, we detected 317 Twitter/X users. Figure 1 represents a visualization of the social network of the Twitter/X users with their interactions related to the hashtags. This social network mapping helps to identify influential users, communication patterns, and the structure of urinary incontinence-related discussions on Twitter/X during the specified period. Fig. 1. Open in a new tab Social network graph of the selected hashtags The figure is divided into several sections. On the left panel (small, isolated nodes shown in dark blue), this section consists of many small clusters representing users who had limited interactions with others in the dataset. These users may have posted using one of the hashtags but did not engage widely through retweets or mentions. On the right panel (densely connected network), this section shows larger, interconnected clusters, indicating a high level of interaction among users. Likewise, a variation in the size of the nodes is also observed, with the largest corresponding to the most influential or key users, who received the most mentions, replies, or retweets. Furthermore, the network is color-coded, with each color representing a distinct subcommunity of users who interact most frequently with each other. These groups can indicate different discussion topics, interest groups, or geographic areas. Likewise, certain users are highlighted with a red outline, suggesting they play a key role in the conversation, either by initiating discussions, being frequently mentioned, or having a significant influence in their respective communities. The thickness of the connecting lines (edges) represents the intensity of interaction between users. Thicker lines indicate greater interaction, such as frequent retweets or direct conversations. Table 1 provides an overview of the top five most active Twitter users within the network. These users have contributed the highest number of tweets within the dataset, playing a key role in the dissemination of information and discussions related to the topic. Table 1. Top tweeters in entire graph Rank Top 5 tweeters User biography (date taken) Entire graph count Locality Followers 1 evankirstel TV host, Tech Influencer, content creator, Industry Espert w/600 K followers, focus on #Enterprise #Cloud #5G #AI #Telecom #Cyber (12/03/2025) 1,206,535 Boston, MA, USA 369.7M 2 guardian This account has been archived. Follow us on the guardian.com or download our app (12/03/2025) 861,591 London 10.7M 3 newindianxpress All the tweets for braking news and views Facebook: https://www.facebook.com/thenewindianxpress Instagram: https://www.instagram.com/newindianexpress/ (12/03/2025) 757,879 Chennai 491.9M 4 abc_es Somos ABC, tu periódico, Instragram: https://www.instagram.com/abc_diario/ Tik Tok: https://www.tiktok.com/@abc.es LinkedIn https://www.linkedin.com/company/diario-abc/ Facebook https://www.facebook.com/ABCes (12/03/2025) 680,775 Spain 2.3M 5 europapress Perfil oficial de la agencia de noticias privada líder en España Encuéntranos en nuestras redes sociales https://linkin.bio/europapress/ (12/03/2025) 656,130 Spain 1.5M Open in a new tab The most active user is Evan Kirstel, a tech influencer and content creator based in Boston, MA, with a focus on enterprise technology, AI, and cybersecurity. He has amassed a significant following of 369.7 million followers and has contributed extensively to the conversation, with an entire graph count of over 1.2 million interactions. The second most active user is The Guardian, a renowned news organization based in London, with 10.7 million followers. Although its Twitter account has been archived, its content remains widely shared within the network, accumulating 861,591 interactions. In the third position, The New Indian Express, a news outlet from Chennai, has actively participated in discussions, generating 757,879 interactions. The account regularly shares breaking news and views, using multiple platforms such as Facebook and Instagram to amplify its reach. The fourth-ranked user is ABC España, a Spanish newspaper that maintains a strong social media presence across Instagram, TikTok, LinkedIn, and Facebook. With 680,775 interactions and 2.3 million followers, it is a key contributor to the online discourse. Finally, the fifth most active user is Europa Press, a leading private news agency in Spain, known for its broad coverage and reliable reporting. With 656,130 interactions and 1.5 million followers, it has a significant role in spreading relevant content within the network. Table 2 provides an overview of the most influential users on the network based on their betweenness centrality. It is important to note that betweenness centrality refers to the influence a user exerts over others through their tweets. Additionally, the concept of influence relates to a user’s popularity or reputation within the social network, calculated using the betweenness centrality metric. The study identified the top five most influential users based on their betweenness centrality scores. Table 2. Overview of the top five influential users Rank Top 5 users, ranked by betweenness centrality User biography (date taken) Betweenness centrality Locality 1 wfip_official The World Federation for Incontinence and Pelvic Problems—WFIPP, official Twitter account (12/03/2025) 4520.4 no location listed in profile 2 bpadillafdez Urologist, @sinug_org Board Member, Panel member @uroweb GL on Neurourology (12/03/2025) 4415.6 no location listed in profile 3 beatriz_smd No biography in the profile (12/03/2025) 2070 no location listed in profile 4 inconasia National Incontinence Patients Association, Tel. 620,886,363 (12/03/2025) 2050 Spain 5 pheveronique Prof.of Urology @Sorbonne_Univ_ @HopitalTenon, Board of @AFUrologie, @Uroweb Female LUTS Guideline, @UrowebESU, AAEU, @EurUrolOpen, Crystal Matula Award (12/03/2025) 1697.3 France Open in a new tab The most influential user within the network is wfip_official, the official account of the World Federation for Incontinence and Pelvic Problems (WFIPP), with a centrality score of 4520.4. Its role as an international organization gives it great relevance in the discussion about incontinence and pelvic problems. In second place is bpadillafdez, a urologist and board member of SINUG and Uroweb, with a centrality score of 4415.6. His participation in specialized neurourology organizations allows him to exert significant influence in the medical field. In third place is beatriz_smd, whose account, despite not having a visible biography, has achieved a centrality score of 2070, indicating a remarkable ability to connect with other users and disseminate relevant information. In fourth place, with a centrality of 2050, is inconasia, the official account of the National Incontinence Patients Association in Spain. Its presence online reflects the importance of patient organizations in raising awareness about incontinence. Finally, in fifth place is pheveronique, a professor of urology at Sorbonne Université and a member of several scientific associations. With a centrality of 1697.3, her influence is based on her specialization in female LUTS guidelines and her participation in multiple urology initiatives. Table 3 provides an overview of the top 5 key URLs shared within tweets. The links point to legitimate sources of information, including medical institutions, professional organizations, and awareness campaigns related to incontinence. Table 3. Top URL visited by group Group Title Institution, domain URL Count 1 Qu’est-ce que l’hyperactivité vésicale? Medtronic, France https://www.medtronic.com/fr-fr/patients/traitements-therapies/overactive-bladder.html 2 2 Infografías Sociedad Iberoamericana de Neurología y Uro Ginecología, Spain https://www.sinug.org/pacientes/infografias/ 1 3 “Aligera su mochila” una campaña para desestigmatizar la incontinencia ABC Sociedad, Spain https://www.abc.es/sociedad/aligera-mochila-campana-desestigmatizar-incontinencia-20240618133615-vi.html?ref=https%3A%2F%2Fwww.abc.es%2Fsociedad%2Faligera-mochila-campana-desestigmatizar-incontinencia-20240618133615-vi.html 2 4 World Continence Week 2024: Reflecting and raising awareness British Geriatrics Society, United Kingdom https://www.bgs.org.uk/blog/world-continence-week-2024-reflecting-and-raising-awareness 5 5 Let’s bring incontinence out of the shadows Royal College of Nursing, United Kingdom https://www.rcn.org.uk/news-and-events/Blogs/lets-bring-incontinence-out-of-the-shadows-180624 2 Open in a new tab The most shared URL ( N = 5) is an article published by the British Geriatrics Society (United Kingdom) discussing World Continence Week 2024, emphasizing the importance of raising awareness about continence issues and promoting discussions on the topic. The second most shared URL ( N = 2) belongs to the Royal College of Nursing (United Kingdom) and features a blog post titled “Let’s bring incontinence out of the shadows,” which highlights the stigma surrounding incontinence and the need for better care and awareness. The third most shared URL ( N = 2) is an article published by ABC Sociedad (Spain) about the campaign “Aligera su mochila,” which seeks to destigmatize incontinence and encourage open discussions on the condition. The fourth most shared URL ( N = 2) comes from Medtronic (France) and provides medical information on overactive bladder, including treatment options for patients. The final URL ( N = 1) belongs to the Sociedad Iberoamericana de Neurología y Uro-Ginecología (Spain) and provides infographics related to continence health. Table 4 shows the most frequently used hashtags across different groups within the network. It can be seen that group 1 has used the hashtag #incontinence the most (90 times), followed by #urinaryincontinence (64 times) and #wcw2024 (41 times). Group 4 also exhibits high hashtag usage, with #wcw2024 appearing 38 times and #worldcontinenceweek2024 22 times. While #wcw2024 is present in multiple groups, it is especially prominent in groups 1, 2, 3, 4, and 5, indicating a common discussion theme across different user clusters. Similarly, hashtags such as #continencematters and #sinug appear in multiple groups, suggesting shared topics of interest related to incontinence awareness and professional discussions. Table 4. Top hashtags in tweets from the top five most active groups Group 1 (Hashtag, n ) Group 2 (Hashtag, n ) Group 3 (Hashtag, n ) Group 4 (Hashtag, n ) Group 5 (Hashtag, n ) Incontinence (90) wcw2024 (7) wcw2024 (8) wcw2024 (38) wcw2024 (12) Urinaryincontinence (64) worldcontinenceweek2024 (4) dejadeescapar2024 (4) worldcontinenceweek2024 (22) Continence (6) wcw2024 (41) wcw24 (4) Incontinenciaanal (2) Sinug (12) Continencematters (4) Incontinenceawareness (15) Sinugpacientes (3) Aligerasumochila (2) Continencematters (10) Bladder (3) Continencematters (14) Semanamundialdelacontinencia (3) Abordaje (1) Infografíassinug (7) Bowel (3) Bladderhealth (13) semanamundialdelacontinencia2024 (2) Incontinenciaurinaria (1) Sinugpacientes (5) Incontinence (2) Worldcontinenceweek (13) Neuromodulacionsacra (2) Congresonacional (1) Supportincontinence (3) Supportincontinence (1) Incontinenceproducts (12) Toxinabotulinica (1) Asociacionincontinenciaasia (1) wcw24 (2) Confidenceapp (1) Continence (10) Lacer (1) Worldcontinenceweek (1) Frailty (2) Rcn (1) Urology (10) Aligerasumochila (1) Incontinence (1) Somossinug (2) Care (1) Open in a new tab In contrast, group 3 presents a more fragmented hashtag distribution, with most hashtags appearing only once, except for #wcw2024 (8 times) and #dejadeescapar2024 (4 times). This pattern could indicate a broadcast network where a single user or a small group is disseminating content without widespread interaction. Additionally, hashtags related to medical treatments and professional organizations—such as #toxinabotulinica, #neuromodulaciones, and #asociacionincontinenciaclassia—are found in groups 2 and 3, suggesting that these groups might be more focused on clinical discussions or institutional communications. Overall, the distribution of hashtags across groups highlights a combination of awareness campaigns (#wcw2024, #worldcontinenceweek2024), medical topics (#bladderhealth, #supportincontinence), and professional engagement (#sinug, #infografiasinug). The presence of common hashtags across multiple groups suggests interconnectivity between discussions, while the variation in frequency indicates differences in thematic focus between user communities. Discussion During World Continence Week 2024, 317 Twitter/X users engaged in online discussions about urinary incontinence, forming a complex, multi-clustered social network. The network visualization revealed distinct subcommunities with varying interaction intensities, where key opinion leaders, such as medical organizations, healthcare professionals, and patient advocacy groups, played central roles in information dissemination. Notably, wfip_official emerged as the most influential user based on betweenness centrality, followed by leading clinicians and patient groups. The five most active users included high-reach media accounts and influencers, such as Evan Kirstel and The Guardian, who amplified topic visibility. Shared content centered around awareness campaigns and credible health sources, with the most circulated URL originating from the British Geriatrics Society. Hashtag analysis showed widespread use of #wcw2024 and #incontinence across user groups, reflecting both global awareness efforts and professional engagement. Overall, the network demonstrates a strong focus on credible, medical-driven communication, highlighting the importance of interdisciplinary voices in shaping the digital discourse on continence. Our results show that the online conversation about incontinence is dominated by medical organizations, healthcare professionals, and patient associations, indicating a strong focus on disseminating specialized information and supporting those affected. Overall, the reported URLs demonstrate the diverse range of sources used within the discussion, from medical organizations and awareness campaigns to professional associations, all contributing to the dissemination of high-quality information on urinary incontinence. A study analyzing 158 social media posts that included 239 prevention strategies for overactive bladder and stress urinary incontinence assessed the quality of the evidence behind these recommendations [ 21 ]. It found that 29% of posts related to overactive bladder and 36% related to stress urinary incontinence lacked any supporting scientific evidence [ 21 ]. Therefore, it is essential for healthcare professionals involved in the care of incontinence to actively use social media to share and promote evidence-based medical practices. A cross-sectional study conducted in the United States involving 282 respondents examined social media usage patterns [ 3 ]. Nearly half of the participants reported using social media daily, and approximately 42% expressed interest in using social networking platforms to learn more about their health conditions [ 3 ]. However, only 4.9% primarily relied on the internet for information, while 39.4% preferred consulting their obstetrician-gynecologist (OBGYN) regarding pelvic floor concerns [ 3 ]. Thus, while our patients often place their trust in information they find online, it is crucial that we, as OBGYNs, actively share and promote evidence-based medical practices on social media. By doing so, we can help to eliminate misinformation and potentially harmful treatments that may worsen patients’ symptoms and lead to the need for more complex interventions. Our study has both strengths and limitations. One limitation is the exclusive focus on a single social media platform X (formerly known as Twitter). Including additional platforms could have offered a broader and more diverse representation of user engagement. Furthermore, our analysis was confined to English-language content, potentially overlooking more nuanced or culturally specific hashtags used by non-English-speaking communities. Future research on WCW should prioritize sentiment analysis of the content and critically assess the validity of the evidence shared in the posts. Another limitation of our study is that we did not perform repeated analyses over time, for instance examining cumulative use of aforementioned hashtags before and after WCW wee). Such longitudinal analyses could help determine whether the observed effects are sustained, amplified, or diminished over time. Future research should address this to provide a more comprehensive understanding of social media dynamics. In conclusion, our study highlights the significant role of social media, particularly Twitter/X, in raising awareness and fostering dialogue about female incontinence during WCW 2024. Our social network analysis demonstrated active engagement from a diverse group of users, including healthcare professionals, patient organizations, and influential institutions, each contributing uniquely to the conversation. The distinction between the most active tweeters, those generating the highest volume of posts, and the most influential users, those strategically positioned to connect and amplify information, underscores the multifaceted nature of online health communication. Furthermore, the shared URLs and frequently used hashtags reveal a broad dissemination of credible information and a collective effort to destigmatize incontinence. Our findings affirm the value of coordinated social media campaigns in enhancing public education and suggest that future initiatives should continue leveraging such platforms to promote early intervention and improve patient outcomes in female incontinence care. Author’s Contribution EB: project conception/initiation, protocol development, data management, data analysis, data review, manuscript writing, manuscript editing; WA: protocol development, data management, data analysis, data review, manuscript writing, manuscript editing; JVA: data management, data analysis, data review, manuscript writing, manuscript editing; MMM: data management, data analysis, data review, manuscript writing, manuscript editing; BG: project supervision, manuscript editing; KG: project supervision, manuscript editing; BBS: project supervision, manuscript editing. Data Availability The authors will provide the data upon request. Declarations Ethics Approval The institutional review board of Newcastle University (26055/2022) granted ethical approval for this study (26055/2022). Conflicts of Interest E Bilir: received travel and accommodation fees from GSK which is not related to this study. W Ahmed: no conflict of interest. J Vidal-Alaball: received speaker fees from Boehringer-Ingelheim which is not related to this study. M Moreno Martinez: no conflict of interest. Boris Gabriel: Honoria and expenses from INTUITIVE Surgical, Serag-Wiessner, all of them not related to this trial. Kayal Gasimli: no conflict of interest. Bettina Blau-Schneider: Honoria and expenses from INTUITIVE Surgical, PFM Medical, MSD, Seagen, all of them not related to this trial. Footnotes Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. References 1. Patel UJ, et al. Updated prevalence of urinary incontinence in women: 2015–2018 national population-based survey data. Female Pelvic Med Reconstr Surg. 2022;28(4):181–7. [ DOI ] [ PubMed ] [ Google Scholar ] 2. Kacperczyk-Bartnik J, et al. Is it possible to block cancer? The example of #VaginalCancer on Instagram. Int J Gynecol Cancer. 2023;33(9):1488–9. [ DOI ] [ PubMed ] [ Google Scholar ] 3. Mazloomdoost D, et al. Social networking and internet use among pelvic floor patients: a multicenter survey. Am J Obstet Gynecol. 2016;215(5):654 e1-654 e10. [ DOI ] [ PubMed ] [ Google Scholar ] 4. Bhandoria G, et al. Impact of a new gynecologic oncology hashtag during virtual-only ASCO annual meetings: an X (Twitter) social network analysis. JMIR Med Educ. 2024;10:e45291. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 5. Bhandoria G, Bilir E, Uwins C, Mackenzie G, Selcuk I. #goASCO20: Success of a new Twitter hashtag to promote gynaecological oncology specific information during Asco 2020 Virtual Annual Meeting. (e-poster 242). European Society of Gynaecological Oncology State of the Art Conference. Int J Gynecol Cancer 30:Suppl 4, Dec 14–16, 2020, Virtual. 10.1136/ijgc-2020-ESGO.91 6. Uwins C, et al. World gynecologic oncology day: the use of Twitter to raise awareness of gynecologic cancers. AJOG Glob Rep. 2022;2(3):100079. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 7. Bilir E, et al. Social media ambassadors and collaboration with OncoAlert: a European Network of Young Gynae Oncologists study of comparative Twitter analysis of #ESGO2021 and #ESGO2022. Int J Gynecol Cancer. 2023;33(6):964–70. [ DOI ] [ PubMed ] [ Google Scholar ] 8. Jain AJ, et al. The top ten Annals of Surgical Oncology original articles on Twitter/X: 2020–2023. Ann Surg Oncol. 2024. 10.1245/s10434-024-15936-z39495364 [ Google Scholar ] 9. Martinelli F, Ahmed W, Bilir E, Bizzarri N, Kacperczyk-Bartnik J, Nasser S, et al. Gynaecologic cancer conversations on Instagram: a study by the European Network Of Young Gynaecologic Oncologists (ENYGO) Investigating Current Trends And Discussions. (e-poster). European Society of Gynaecological Oncology 24th Conference. Int J Gynecol Cancer. 2023;33:A217–8. 10.1136/ijgc-2023-ESGO.451 [ Google Scholar ] 10. Kacperczyk-Bartnik J, Ahmed W, Bilir E, Martinelli F, Bizzarri N, Nasser S, et al. #HPVvaccination: is the topic of human papillomavirus-related malignancies primary prevention present on Instagram? A European Network Of Young Gynae Oncologists (ENYGO) Study. (e-poster). European Society of Gynaecological Oncology 24th Conference. Int J Gynecol Cancer. 2023;33:A342–3. 10.1136/ijgc-2023-ESGO.722 [ Google Scholar ] 11. Bilir E, Ahmed W, Aida Angeles M, Ergasti R, Martinelli F, Bizzarri N, et al. Investigating current trends and conversations on ovarian cancer on Instagram: a study by the European Network Of Young Gynaecologic Oncologists (ENYGO). (e-poster). European Society of Gynaecological Oncology 24th Conference. Int J Gynecol Cancer. 2023;33:A254–5. 10.1136/ijgc-2023-ESGO.530 [ Google Scholar ] 12. Nasser S, Ahmed W, Bilir E, Martinelli F, Ergasti R, Bizzarri N, et al. Instagram analysis of discussions and trends in vaginal cancer: insights from a European Network Of Young Gynaecologic Oncologists (ENYGO) Study. (e-poster). European Society of Gynaecological Oncology 24th Conference. Int J Gynecol Cancer. 2023;33:A380. 10.1136/ijgc-2023-ESGO.805 [ Google Scholar ] 13. Nasser S, Ahmed W, Bilir E, Martinelli F, Ergasti R, Kacperczyk-Bartnik J, et al. Current conversations and trends in vulvar cancer on Instagram: a study by the European Network Of Young Gynaecologic Oncologists (ENYGO). (e-poster). European Society of Gynaecological Oncology 24th Conference. Int J Gynecol Cancer. 2023;33:A379–80. 10.1136/ijgc-2023-ESGO.804 [ Google Scholar ] 14. Martinelli F, Ahmed W, Bilir E, Bizzarri N, Kacperczyk-Bartnik J, Ergasti R, et al. An Instagram analysis of current discussions and trends in cervical cancer: findings from the European Network Of Young Gynecologic Oncologists (ENYGO) Study. (e-poster). European Society of Gynaecological Oncology 24th Conference. Int J Gynecol Cancer. 2023;33:A61. 10.1136/ijgc-2023-ESGO.122 [ Google Scholar ] 15. Ergasti R, Ahmed W, Bilir E, Martinelli F, Strojna AN, Kacperczyk-Bartnik J, et al. Exploring endometrial cancer conversations on Instagram: insights from a study by the European Network Of Young Gynaecologic Oncologists (ENYGO). (e-poster). European Society of Gynaecological Oncology 24th Conference. Int J Gynecol Cancer. 2023;33:A138–9. 10.1136/ijgc-2023-ESGO.285 [ Google Scholar ] 16. Grabbert M, et al. Comprehensive analysis of Twitter activity on #Incontinence. Neurourol Urodyn. 2020;39(1):440–6. [ DOI ] [ PubMed ] [ Google Scholar ] 17. June 17–23 is World Continence Week! 2024 [cited 2025 09 June 2025]. Available from: https://www.iuga.org/news/news/june-17-23-is-world-continence-week 18. Smith MA, et al. Analyzing (social media) networks with NodeXL. In: Proceedings of the fourth international conference on communities and technologies. University Park: Association for Computing Machinery; 2009. pp. 255–264. 19. Koren Y, Harel D. Axis-by-axis stress minimization. In: Graph drawing. Berlin: Springer. 2004. 20. Clauset A, Newman MEJ, Moore C. Finding community structure in very large networks. Phys Rev E. 2004;70(6):066111. [ DOI ] [ PubMed ] [ Google Scholar ] 21. Pace LA, Herbert AS, Malik RD. Characteristics of pelvic organ prolapse content available on social media. Neurourol Urodyn. 2021;40(5):1165–74. [ DOI ] [ PubMed ] [ Google Scholar ] Associated Data This section collects any data citations, data availability statements, or supplementary materials included in this article. Data Availability Statement The authors will provide the data upon request. Articles from International Urogynecology Journal are provided here courtesy of Springer ACTIONS View on publisher site PDF (697.8 KB) Cite Collections Permalink RESOURCES Similar articles Cited by other articles Links to NCBI Databases Follow NCBI NCBI on X (formerly known as Twitter) NCBI on Facebook NCBI on LinkedIn NCBI on GitHub NCBI RSS feed Connect with NLM NLM on X (formerly known as Twitter) NLM on Facebook NLM on YouTube National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894 Web Policies FOIA HHS Vulnerability Disclosure Help Accessibility Careers NLM NIH HHS USA.gov Back to Top

Related documents

• Global journalism#473426
• Analysing network motifs in a complex network of freight movements#286402
• Global Media and Cultural Domination: Strategies for a New World Information and Communication Order (NWICO) for Arica#726241
• Campaign media content analysis, TV (GLES 2009)#262572
• Scrolling the Nation: Banal Digital Nationalism on Short-Form Video Feeds#1092542