Urinary incontinence (UI) and fecal incontinence (FI) are common pelvic floor disorders with substantial physical, psychological, and economic impacts. Accurate epidemiological data, particularly in developing countries, remain limited. We aimed to determine the prevalence of UI, FI, and their co-occurrence in the general population of northwest Iran.

This cross-sectional study included 1,865 participants (49.8% male, 50.2% female; mean age 36.7 years, range 15–90 years) from urban and rural areas of East Azerbaijan, Ardabil, and Zanjan provinces. Data were collected using validated Persian versions of ICIQ-OAB, ICIQ-FLUTS, ICIQ-MLUTS, and PFDI questionnaires through face-to-face and telephone interviews. Statistical analysis was performed using SPSS, with chi-square tests for associations (p < 0.05 considered significant).

Overall UI prevalence was 10.9%, with significant sex differences (women: 18.7%, men: 3.1%, p < 0.001). Stress urinary incontinence (SUI) was the most common subtype (overall 9.3%), affecting 17.7% of women and 0.8% of men (p < 0.001). Urge urinary incontinence (UUI) prevalence was 3.2%, with no significant sex difference (women: 3.6%, men: 2.8%, p = 0.359). Mixed urinary incontinence (MUI) was reported in 1.6% overall (women: 2.7%, men: 0.4%, p < 0.001). FI prevalence in women was 0.5%. Co-occurrence of UI and FI was observed in 2.3% of women, representing a clinically important subgroup.

This study shows that urinary incontinence (UI) is relatively common in northwest Iran, with a clear predominance in women, consistent with known anatomical and obstetric risk factors. The overall prevalence appears moderate compared to global data, possibly reflecting the relatively young population and underreporting due to social stigma. Stress urinary incontinence (SUI) was the dominant subtype, particularly in women, highlighting the role of pelvic floor dysfunction. In contrast, urge urinary incontinence (UUI) showed similar rates between sexes, suggesting less sex-specific mechanisms. The low reported prevalence of fecal incontinence (FI) may also be influenced by underreporting. Although double incontinence was uncommon, its presence identifies a clinically important subgroup with likely more severe pelvic floor dysfunction. Overall, these findings emphasize the need for improved awareness, screening, and targeted interventions, especially among women.

UI is significantly more prevalent in women than men in northwest Iran, with SUI being the predominant subtype. Although FI and double incontinence have lower prevalence, their clinical significance warrants attention. These findings highlight the need for targeted screening and public awareness programs.