<![CDATA[HIGHLIGHTS The study demonstrates that obesity significantly increases the risk of urinary dysfunction and urinary tract infections in women with Polycystic Ovary Syndrome (PCOS). These findings highlight the importance of a multidisciplinary and holistic management approach that addresses not only reproductive and metabolic aspects but also urogenital health in obese women with PCOS. ABSTRACT Objective: To evaluate whether the combination of PCOS and obesity increases the risk of urinary dysfunction and UTIs in women of reproductive age compared with overweight women with PCOS. Materials and Methods: This retrospective cross-sectional study included women aged 18–45 years who met the Rotterdam criteria for PCOS and had a BMI ≥23 kg/m² at Dr. Moewardi Hospital Surakarta from January 2024 to May 2025. Subjects with chronic diseases or recent surgery, antibiotic use, or hormone therapy were excluded. Participants were categorized as overweight (23–24.9 kg/m²) or obese (≥25 kg/m²). Urinary dysfunction symptoms and UTI incidence were extracted from medical records. Associations were analyzed using the Chi-square or Fisher’s exact test, with p<0.05 considered statistically significant. Odds Ratios (ORs) with 95% Confidence Intervals (CIs) were calculated. Results: Of 37 women screened, 31 met the inclusion criteria. The mean age was 31.2±4.1 years, and the mean BMI was 25.4±1.5 kg/m². Urinary dysfunction was significantly more prevalent in obese than overweight women (91.7% vs. 15.8%; p<0.001). Similarly, UTIs were significantly more frequent among obese women (83.3% vs. 21.1%; p=0.001). Obesity was associated with substantially increased risks of urinary dysfunction (OR = 33.0; 95% CI: 4.2–257.3) and UTIs (OR = 18.7; 95% CI: 2.8–123.5). These findings suggest that increasing adiposity may contribute to urogenital complications and underscore the importance of early urological assessment. Conclusion: Obesity is significantly associated with increased urinary dysfunction and UTIs in women with PCOS, supporting the integration of urological screening into the routine management of obese women with PCOS.]]>
