Urinary incontinence (UI) is a debilitating disease which could have a negative impact on social, physical, and psychological aspects of many individuals. Previous studies have focused mainly on parity and aging as the predisposing factors of UI. Other risk factors, the severity of UI and quality of life of these women have not been thoroughly evaluated. The purpose of our study was to examine the prevalence, quality of life (QoL), severity and different types of urinary incontinence in overweight and obese women using an internationally validated questionnaire form.

We conducted a cross-sectional study of 1351 consecutive patients, who were recruited between June 2021 and May 2022. An internationally validated screening tool-International Consultation on Incontinence Questionnaire- Urinary Incontinence Short Form (ICIQ-UI-SF) was used to assess the frequency, amount of leakage, impact of urinary incontinence on quality of life, severity and types of urinary incontinence.

The mean age of the patients was 39.7±14.2 years with less than a half in the 19–35 year age bracket (46.9 %) and most participants were overweight or obese (65.0 %). The overall prevalence of UI was 61.2%. Overweight and obesity accounted to 70.2% of patients with mild to very severe UI. The risk estimates to have UI were 1.84 in overweight group and 5.4 in obese group. The risk estimate for severe and very severe urinary incontinence was 2.33 in overweight group and 10.34 in obese group. When considering all subtypes, 67.9% of women with overweight and obesity had any of the subtypes-UUI, SUI and MUI. Overweight and obesity was significantly associated with poor QoL in women with UI (p<0.0001). Among 36.1% of all patients with poor QoL, 79.9% were overweight and obese.

UI was encountered in 55.2% of premenopausal and 81.4% of postmenopausal women (P values <0.0001, 95% CI 7.1-17.5). The prevalence of UI in nulliparous women was 43.7%, in women with 1-2 deliveries 65.2% and in those with ≥3 deliveries 76.9%. Urinary incontinence was reported in 60% of overweight women and 81.4% of obese women, with risk of 1.86 in overweight and 5.45 in obese women. The risk of developing mild, moderate, and severe with very severe UI in overweight women are 1.47, 1.99 and 2.33. In obese women, the risk increased to 3.81, 4.95 and 10.34 in mild, moderate, or severe and very severe UI respectively.67.9% of overweight and obese women suffered from any subtypes of UI (SUI, UUI or MUI). In overweight women, the risk estimate was 2.20 for UUI, 1.71 for SUI and 2.20 for MUI. In women with obesity, the risks to have UUI, SUI or MUI were 5.73, 5.88 and 8.34 respectively. Poor QoL due to UI was reported by women in 36.1% of cases. Among these women, 79.9% were overweight and obese. The estimate risk to suffer from poor QoL with UI in overweight and obese groups was 2.11 and 4.35.

Overweight and obesity are important risk factor of urinary incontinence affecting daily activity and quality of life considerably. Since more people suffer from obesity, the prevalence of UI with increased severity is likely to increase in young to mid-aged women. Weight loss should be considered as first line treatment for this patient population.