Polycystic Ovary Syndrome (PCOS) and obesity: do they increase the risk of urinary dysfunction and urinary tract infections?

Asih Anggraeni (Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta Department of Obstetrics and Gynecology, UNS Hospital, Surakarta)
Uki Retno Budihastuti (Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta Department of Obstetrics and Gynecology, Dr. Moewardi Hospital, Surakarta)
Eriana Melinawati (Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta Department of Obstetrics and Gynecology, Dr. Moewardi Hospital, Surakarta)
Abdurahman Laqif (Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta Department of Obstetrics and Gynecology, Dr. Moewardi Hospital, Surakarta)
Agung Sari Wijayanti (Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta Department of Obstetrics and Gynecology, Dr. Moewardi Hospital, Surakarta)
Intan Rachmawati (Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta Department of Obstetrics and Gynecology, Dr. Moewardi Hospital, Surakarta)

Majalah Obstetri dan Ginekologi
Vol. 34 No. 2 (2026): August

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.