Prevalence and determinants of urinary incontinence among adult women in the Democratic Republic of Congo: a community-based cross-sectional study

Urinary incontinence (UI) is defined as any complaint of involuntary urine leakage. In the Democratic Republic of Congo (DRC), no community-based data on UI prevalence among adult women are currently available. This study aims to determine the UI prevalence, the associated discomfort, and the risk factors among adult women in the DRC. A community-based cross-sectional study was conducted between 2021 and 2023, involving 507 adult women across six provinces of the DRC. A multistage, geographically and ethnolinguistically stratified sampling approach was used. Pregnant or postpartum women ≤ 6 months, survivor of sexual violence and those with vesicovaginal fistulas were excluded. Data collection included the ICIQ-FLUTS questionnaire to assess urinary symptoms. Binary logistic regression was performed to identify the risk factors of UI (p < 0.05). The prevalence of UI was 31% (95% CI: 27–35.2%), with 51% of affected women reporting associated discomfort. Urgency urinary incontinence (63.7%; 95% CI: 55.7–71.2) was more frequently reported than stress urinary incontinence (11.5%; 95% CI: 6.9–17.5). UI was independently associated with occupations involving high-intensity physical activity (aOR: 1.56; 95% CI: 1.01-2.43), body mass index (aOR: 1.06; 95% CI: 1.01-1.11), constipation (aOR: 1.95; 95% CI: 1.19-3.18), episiotomy (aOR: 1.72; 95% CI: 1.09-2.72), perineal tears (aOR: 1.77; 95% CI: 1.01-3.20), and the practice of labia minora elongation (aOR: 2.01; 95% CI: 1.12-3.58). UI is a multifactorial condition that affects one-third of adult women in the DRC and causes discomfort in nearly half of those affected.