{
  "abstract": "Background\n\nUrinary incontinence (UI) in young women is increasingly recognized but remains under-reported and insufficiently addressed. While physical activity has been implicated in pelvic floor dysfunction, evidence regarding its relationship with urinary incontinence remains heterogeneous and context-dependent. This study aimed to evaluate UI prevalence, symptom burden, and knowledge, and to explore perceptions and care-seeking behaviors among young women.Methods\n\nA nationwide mixed-methods comparative study was conducted among 461 women aged 18-40 years in Thailand. Participants were categorized into three groups based on physical activity levels: athletes (n = 141), recreationally active (n = 152), and sedentary (n = 168). Quantitative data were collected using validated questionnaires including ICIQ-UI SF, IIQ-7, and PIKQ-UI which assessed UI severity, impact on quality of life, and knowledge of urinary incontinence, respectively. Multivariable regression analyses were performed to assess associations between activity level and outcomes. In-depth interviews were conducted with 30 participants and analyzed using reflexive thematic analysis. Findings were integrated using an explanatory sequential approach.Results\n\nOverall, 30.8% of participants reported UI, with prevalence decreasing across activity levels (39% sedentary, 30% recreationally active, 22% athletes; p = 0.004). Athletes had significantly lower odds of UI compared with sedentary women (adjusted OR 0.45, 95% CI 0.25-0.80; p = 0.007). Physical activity was not associated with symptom severity among symptomatic individuals. Both athletes and recreationally active women reported lower quality-of-life impact compared with sedentary participants (adjusted OR 0.55 and 0.52, respectively). Despite these favorable outcomes, athletes demonstrated significantly lower pelvic floor knowledge (adjusted OR 0.17, 95% CI 0.08-0.34; p < 0.001), indicating a knowledge-behavior gap. Qualitative findings revealed consistent themes of age-related misperception, symptom normalization, stigma, and delayed care-seeking. Participants commonly relied on self-management and informal information sources, and a substantial gap between PFMT awareness and practice was identified.Conclusion\n\nUI in young women in this study population represents an under-recognized public health issue, with prevalence highest among sedentary individuals. While physical activity is associated with lower UI prevalence and better quality-of-life outcomes, significant gaps in pelvic floor knowledge and health-seeking behavior persist, particularly among athletes. Integrated, behaviorally informed interventions are needed to improve awareness, promote preventive practices, and address system-level barriers in this population.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Obstetrics and Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd. Phayathai, Bangkok, 10400, Thailand.",
    "Department of Obstetrics and Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd. Phayathai, Bangkok, 10400, Thailand. apisith.sar@mahidol.ac.th."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Varis Ratanaarsanarom"
    },
    {
      "affs": [
        0
      ],
      "name": "Komkrit Aimjirakul"
    },
    {
      "affs": [
        0
      ],
      "name": "Jittima Manonai"
    },
    {
      "affs": [
        0
      ],
      "name": "Rujira Wattanayingcharoenchai"
    },
    {
      "affs": [
        0
      ],
      "name": "Orawee Chinthakanan"
    },
    {
      "affs": [
        1
      ],
      "name": "Apisith Saraluck",
      "orcid": "0000-0003-0528-7031"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cdgmaav0yev58.bib",
  "cited_by": 0,
  "doi": "10.1186/s12889-026-28843-7",
  "fulltext_url": "https://europepmc.org/articles/PMC13729592",
  "id": "cdgmaav0yev58",
  "issns": [
    "1471-2458"
  ],
  "landing_url": "https://europepmc.org/article/MED/42972333",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2745|Pelvic floor disorders treatments"
    ]
  ],
  "openalex": "W7196952793",
  "pdf_url": "https://europepmc.org/articles/PMC13729592?pdf=render",
  "pmcid": "PMC13729592",
  "pmid": "42972333",
  "published": "2026-08-06",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/cdgmaav0yev58.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:49Z",
      "native_id": "MED:42972333",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42972333"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:1471-2458",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Urinary incontinence symptoms and knowledge across activity levels in young women (UI-SKY Project): a mixed-methods comparative study.",
  "title_text": "Urinary incontinence symptoms and knowledge across activity levels in young women (UI-SKY Project): a mixed-methods comparative study.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T03:21:01Z",
  "url": "https://research.draconitic.com/paper/cdgmaav0yev58",
  "venue": "BMC public health",
  "versions": []
}