Urinary incontinence in Ugandan gynecologic outpatient clinics: Prevalence, clinical types, and associated factors

Urinary incontinence (UI) is a common but underrecognized condition among women, including within routine gynecologic outpatient care, particularly in low- and middle-income countries. Evidence from referral-level gynecologic outpatient settings in Uganda remains limited. This study therefore determined the prevalence, clinical types, and associated factors of UI among women attending gynecologic outpatient clinics in Uganda. A cross-sectional study was conducted among 374 non-pregnant women attending gynecologic outpatient clinics at Kayunga and Jinja Regional Referral Hospitals (RRH). UI and its clinical types were assessed using the Questionnaire for Urinary Incontinence Diagnosis (QUID). Data on associated factors were collected using structured interviews, and multivariable logistic regression was used to identify factors independently associated with UI. Among the 374 women enrolled, 103 had UI, giving a prevalence of 27.5% (95% confidence interval [CI]: 23.1 to 32.3). The most common subtype was stress UI (44.7%), followed by urgency UI (30.1%) and mixed UI (25.2%). Increasing age was independently associated with UI, with higher odds among women aged 30-39 years (adjusted odds ratio [AOR] 2.03, 95% CI 1.00 to 4.10), 40-49 years (AOR 2.63, 95% CI 1.18 to 5.88), and 50 years or older (AOR 4.95, 95% CI 1.25 to 19.56) compared with women younger than 30 years. No formal education (AOR 4.34, 95% CI 1.29 to 14.55), high parity of four or more deliveries (AOR 2.97, 95% CI 1.21 to 7.26), and prolonged labor lasting more than 24 hours (AOR 2.46, 95% CI 1.37 to 4.40) were also independently associated with UI. Urinary incontinence affected approximately one in four women attending gynecologic outpatient clinics in Uganda, with stress UI as the predominant subtype. Routine UI screening in gynecologic outpatient services and strengthened obstetric and postpartum care may help reduce the burden of UI in similar referral settings.