We hypothesized that women with endometriosis present a higher frequency of lower urinary tract symptoms (LUTS) and that clinical variables may influence their occurrence. Therefore, this study aimed to assess the presence of LUTS in women with endometriosis and to investigate the association between clinical variables and urinary incontinence.

This cross-sectional study was derived from a longitudinal study and included adult women diagnosed with endometriosis and followed at a specialized center. Sociodemographic (age, marital status, education) and clinical data (parity, waist circumference, body mass index, physical activity, bowel function, and menstrual cycle characteristics) were collected.
Urinary symptoms were assessed using validated instruments: the International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF), the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms (ICIQ-FLUTS), including storage, voiding, and urinary incontinence domains, and the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB).
Descriptive statistics were used to present means, standard deviations, and absolute and relative frequencies. Multiple linear regression analysis was performed, considering the ICIQ-SF score as the dependent variable. Statistical significance was set at 5%.
The study was approved by the Research Ethics Committee, and all participants provided written informed consent.

A total of 133 women were included. The mean age was 33.8±8.42 years, and the mean body mass index was 27.7±6.14 kg/m². Regarding sociodemographic characteristics, 48.3% were married or in a stable relationship and 36.8% were single. Higher educational level was reported by 42.4%, and 64.9% engaged in physical activity. Most participants had a regular menstrual cycle (65.7%) and normal bowel function (80.0%).
The mean ICIQ-SF score was 5.77±6.47. Regarding symptom severity, 41.4% reported no urinary incontinence, while 20.3% had mild, 9.0% moderate, 18.0% severe, and 11.3% very severe symptoms. Urinary leakage most frequently occurred during coughing or sneezing (n=26), followed by physical activity (n=21) and during sleep (n=19). Leakage after voiding or while dressing was reported by 10 participants, and before reaching the toilet by 8. Less frequent situations included continuous leakage (n=6) and leakage without an apparent reason (n=5).
The mean ICIQ-OAB score was 5.48±3.41. For the ICIQ-FLUTS, mean scores were 5.79±3.45 for storage symptoms, 3.00±2.71 for voiding symptoms, and 4.26±4.77 for urinary incontinence.
Multiple linear regression analysis showed no statistically significant association between ICIQ-SF scores and the independent variables: age (β = -0.16; p = 0.565), parity (β = 0.26; p = 0.924), waist circumference (β = 0.39; p = 0.184), physical activity (β = 1.15; p = 0.821), bowel function (β = 1.37; p = 0.917), and menstrual cycle (β = 2.88; p = 0.721). The model showed an R² of 0.4286 and was not statistically significant (F = 0.875; p = 0.556).

A substantial proportion of participants did not report urinary incontinence; however, among symptomatic women, a relevant percentage presented severe and very severe symptoms, indicating a heterogeneous clinical profile. The predominance of leakage during effort-related situations suggests an important component of stress urinary incontinence, while the presence of urgency-related episodes and higher storage scores indicate concomitant urgency symptoms.

Women with endometriosis predominantly presented absent or mild LUTS; however, a clinically relevant proportion reported severe and very severe urinary incontinence. The findings indicate a heterogeneous symptom profile, with predominance of storage symptoms and features suggestive of both stress and urgency urinary incontinence. No associations were identified between clinical variables and urinary incontinence. These findings should be interpreted with caution due to methodological limitations, particularly the reduced sample size for inferential analysis.

Gabriel I, Vitonis AF, Missmer SA, et al. Association between endometriosis and lower urinary tract symptoms. Fertil Steril. 2022;117(4):822-830. doi:10.1016/j.fertnstert.2022.01.003
Muriithi FG, Vij M, Mukherjee S, Emery S. A Systematic Review of the Prevalence of Overactive Bladder in Women with Non-Urinary Tract Endometriosis and the Effect of Endometriosis Surgery on Symptoms of Overactive Bladder. Int Urogynecol J. 2025;36(4):741-748. doi:10.1007/s00192-024-06018-5