Abstract
BACKGROUND: Urinary incontinence (UI) and associated lower urinary tract symptoms (LUTS) are well documented in older, multiparous women, with established risk factors such as menopause, neurological disorders, and diabetes mellitus. However, emerging evidence indicates that young, nulligravid women without these traditional risk factors may also be affected. This study explores the prevalence, risk factors, and impact of UI and LUTS in this population. METHODS: A cross-sectional study was conducted using an anonymous online questionnaire adapted from the International Consultation on Incontinence Questionnaire for Female Lower Urinary Tract Symptoms and the Lower Urinary Tract Symptoms Quality of Life. Participants were women aged 18-25 years who had never been pregnant. RESULTS: Approximately one-third of participants reported experiencing UI (urge, stress, or mixed incontinence), whereas 45.9% reported at least one LUTS without UI. Significant associations were identified between UI and increased body mass index (p = 0.007), smoking (p = 0.018), and recurrent urinary tract infection (p = 0.004). Toilet behaviors, such as delaying urination until bladder fullness, were also significantly associated with UI. Logistic regression analysis identified key predictive risk factors for UI: being overweight or obese (odds ratio [OR] = 1.88, confidence interval [CI] = 1.22-2.90), smoking (OR = 3.07, CI = 1.32-7.12), and delaying bladder emptying (OR = 2.99, CI = 1.63-5.47). Women with UI self-reported significant bother from symptoms, particularly those with overactive bladder (urge incontinence: 72.3%, urinary urgency: 53.6%, and nocturia: 55.4%). Quality of life was notably impacted, with 28.3% of participants with urge incontinence requiring daily pad use. Despite this, the majority (85.1%) did not seek medical care. CONCLUSIONS: UI and LUTS are prevalent in young nulligravid women, with modifiable risk factors such as lifestyle habits and toilet behaviors playing a critical role. These findings highlight the need for community awareness programs and proactive patient education during clinical encounters, as affected women are unlikely to seek medical advice voluntarily.