The burden of urinary incontinence and its association with knowledge, practices, and comorbidities among women in Madinah, Saudi Arabia: a cross-sectional study

Background: Urinary incontinence (UI) is a prevalent and debilitating condition that significantly impairs quality of life. While risk factors are well-documented globally, data on its prevalence, associated knowledge, and related practices among women in specific regions of Saudi Arabia remain scarce. Objective: This study aimed to determine the prevalence of UI, assess women's knowledge and practices regarding the condition, and identify associated sociodemographic and clinical factors among women in Madinah, Saudi Arabia. Methods: A community-based, cross-sectional online survey was conducted between June and August 2024 among 394 Saudi women aged 25-65 years in Madinah, recruited via convenience sampling through social media platforms (WhatsApp, X, and Telegram). A self-administered questionnaire collected data on sociodemographics, health characteristics, UI prevalence (over the past 6 months), and a 16-item knowledge and 4-item practices scale. Statistical analyses included descriptive statistics, Mann-Whitney U/Kruskal-Wallis tests, and binary logistic regression to identify factors associated with UI. Results: = 118). Among the total sample, symptoms suggestive of stress UI were most common (52.8%), followed by urge (35.8%), mixed (34.3%), and overflow UI (19.0%). Participants demonstrated moderate general knowledge (mean score: 8.95 ± 2.30 out of 16) but markedly low understanding of specific UI types (e.g., only 10.9% knew the difference between stress and urge UI). Negative health-seeking practices were reported, including neglecting treatment due to embarrassment (16.8%) and hesitancy to consult a doctor (19.3%). Logistic regression revealed that older age (46-55 years: OR = 3.22, 95% CI: 1.57-6.60; 56-65 years: OR = 3.41, 95% CI: 1.23-9.44), being married (OR = 2.61, 95% CI: 1.19-5.73), overweight (OR = 1.96, 95% CI: 1.11-3.47), obesity (OR = 2.97, 95% CI: 1.66-5.32), constipation (OR = 2.20, 95% CI: 1.30-3.72), chronic cough (OR = 3.67, 95% CI: 1.52-8.85), diuretic use (OR = 2.75, 95% CI: 1.09-6.95), hypercholesterolemia (OR = 2.41, 95% CI: 1.45-3.99), history of UTI (OR = 2.34, 95% CI: 1.48-3.92), and more negative practices (OR = 2.94, 95% CI: 2.31-3.72) were significant independent predictors of UI. Knowledge score was not a significant predictor. Conclusion: UI is a common condition among women in Madinah, strongly associated with a profile of demographic and clinical factors. The critical gap in specific UI knowledge and the prevalence of negative health-seeking behaviors highlight an urgent need for public health campaigns that address these specific deficits and routine, sensitive screening for high-risk groups to bridge the treatment gap.