Prevalence and Associated Factors of Female Lower Urinary Tract Symptoms in the Democratic Republic of Congo: A...

Female lower urinary tract symptoms (FLUTS) are common but often underrecognized, particularly in low-resource settings such as the Democratic Republic of Congo (DRC). This study was aimed at assessing the prevalence, severity, and associated factors of FLUTS in the DRC.

A community-based cross-sectional study was conducted between 2021 and 2023 across six provinces in the DRC. A total of 507 women (≥ 18 years old) were recruited using a multistage, geographically and ethnolinguistically stratified sampling approach. Pregnant and postpartum women (≤ 6 months), survivors of sexual violence, and those with vesicovaginal fistulas were excluded. Data collection included the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS). Multivariable logistic regression identified risk factors.

The prevalence of any FLUTS was 77.3% (95% CI: 73.4-80.9%), with storage symptoms (75.9%) more common than voiding symptoms (8.1%). Nocturia (63.1%), urgency (41.6%), and urgency urinary incontinence (26.8%) were the most common storage symptoms, whereas hesitancy (5.9%) and straining (3%) were the most frequent voiding symptoms. Among women with LUTS, 30.1% reported discomfort, mostly linked to insensible incontinence (100%), stress urinary incontinence (61.1%), and nocturnal enuresis (62.9%). High parity (aOR: 1.09; 95% CI: 1.01-1.19) and a profession involving high-intensity physical activity (aOR: 1.60; 95% CI: 1.01-2.55) were significant risk factors for FLUTS.

Lower urinary tract symptoms are highly prevalent among Congolese women, but only a third experience significant discomfort. Targeted interventions are needed to improve awareness, prevention, and management strategies to inform national-health policies and strengthen community-level interventions.