Prevalence And Risk Factor Of Overactive Bladder Syndrome Among Egyptian Medical Students And Their Impact On Health-Related Quality Of Life, Cross-Sectional Study
Conditions: Overactive Bladder Syndrome
Sponsor: Zagazig University

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Official Name: Prevalence And Risk Factor Of Overactive Bladder Syndrome 
Among Egyptian Medical Students And Their Impact On Health-Related 
Quality Of Life, Cross-Sectional Study  
Authors 
Ahmed M. Eliwa 
Assistant professor of urology, Zagazig University, Zagazig, Egypt. 
Abdelmonam M Hagag 
Faculty of Medicine, Zagazig University, Zagazig, Egypt 
Ahmed Fayez Mohamed  
Faculty of Medicine, Merit University, New Sohag, Egypt 
Abdullah Khaled Rezk 
  Faculty of Medicine, Mansoura University, Mansoura, Egypt 
Ibrahim Essam Elshaikh  
Faculty of medicine, Merit university, New Sohag, Egypt  
Asmaa Hamdy Abdellatif  
Faculty of Medicine, South Valley University, Qena, Egypt.  
May Mahmoud Elgamal 
Faculty of Medicine, Kafr Elsheikh University, Kafr Elsheikh, Egypt 
 
Clinical Trial registration Number: Not yet registered 
Date of the document: 18/ May 2025 
Study time: 2025-2026 
 
 
 
 

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Introduction 
Overactive bladder (OAB) is defined as sudden, urgent desire to urinate (urgency) 
accompanied by frequency and nocturia, with or without urgent urinary incontinence in the 
absence of urinary tract infection (UTI)(Abrams et al., 2003; D’Ancona et al., 2019). This 
condition can significantly decrease the quality of life of these patients(Foley et al., 2019), as it 
can humiliate their actions, affect their relationships with others, and it can also affect their 
productivity. Due to all these effects, several studies have linked the increase in overactive 
bladder symptoms with an increase in anxiety and depression rates.(Coyne et al., 2004; Lai et al., 
2016; Mehr et al., 2022). A recent cross-sectional study in the UK and Sweden, called EpiLUTS, 
included 10,000 participants. They found a statistically significant increase in anxiety and 
depression rates among both men and women in both the UK and Sweden, with a slight increase 
in men than women(Coyne et al., 2011) 
On the other hand, there are several risk factors such as overweight, smoking, diabetes, 
and hypertension (Chae et al., 2018; Link et al., 2011; Tähtinen et al., 2011). In a previous cross-
sectional study in Jordan, they found a correlation between an increase in risk factors such as age 
group, history of trauma, stressful life, and medication, and overactive bladder symptoms among 
medical students(Abuorouq et al., 2024). 
Several studies have assessed the prevalence of overactive bladder among different 
population age groups, ethnicities, or genders with varying results. It was rated to be 11.8% in a 
multicenter cross-sectional study including several countries in Canada and Europe (Germany, 
Italy, Sweden, and the UK (Irwin et al., 2006), while in the USA it was estimated to be 16% 
(Stewart et al., 2003). All these studies were conducted on the general population; however, in 
China, it was about 6% among university students (Liang et al., 2022).  
In the Arab world, several cross-sectional studies have also assessed the prevalence of 
overactive bladder, including students, and its effect on the quality of life. Hajjar 2022 (Hajjar et 
al., 2022) assessed its prevalence among Lebanese female nulliparae university students. They 
showed that nocturia and frequency were the most common symptoms that bothered students. 
They also found a statistical correlation between smoking, drinking coffee, or tea, and increased 
symptoms. Also, drinking soft drinks was associated with an increase in urinary leakage. 
Additionally, Abuorouq 2024(Abuorouq et al., 2024) and Shawahna 2021(Shawahna et al., 2021) 

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Cross-sectional studies were conducted on medical students in Jordan and Palestine, respectively. 
They reported a prevalence of 44.5% and 54.1%, respectively. Shawahna 2021(Shawahna et al., 
2021) reported a statistically significant correlation between gender or stressful life and a 
decrease in quality of life.  
Rational 
In Egypt, the prevalence of overactive bladder is underestimated. A single previous 
multinational cross-sectional study across several Arab countries, including Egypt, was 
conducted. (Al Edwan et al., 2021) was conducted in Egypt, Algeria, Jordan, and Lebanon 
among women. They reported a prevalence of 57.5%  among Egyptian women. 
 Since this study, no study has been conducted to further assess its prevalence in different 
age or gender groups in Egypt. Taking into consideration the stressful life of medical students in 
Egypt, and several life risk factors they face, we will conduct this cross-sectional study. 
No previous cross-sectional study was conducted on the medical students in Egypt 
before. 
 We aim to assess the prevalence of overactive bladder among Egyptian medical students. 
We will also assess the risk factors associated with an increase in this condition and its effect on 
their quality of life. 
Research Questions 
What is the prevalence of the overactive bladder among Egyptian medical students, how can 
this affect their quality of life, and what are the risk factors that can increase its prevalence? 
 
 
 
 
 
 

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Hypothesis 
We hypothesize that overactive bladder is a common condition in Egyptian medical students. 
Aim:  
Improve the quality of life of medical students by addressing the prevalence of overactive 
bladder and its risk factors 
Objective 
• To assess the prevalence of overactive bladder among Egyptian medical students. 
• To assess its effect on their quality of life 
• To address the risk factors that can increase the prevalence of this condition. 
Methodology 
A. Technical design 
• Study design: Analytical cross-sectional study 
• Study sitting: a medical student in Egypt will be accessed through an online 
questionnaire. 
• Study population: Egyptian Medical students studying medicine in Egypt. 
• Time: 2025-2026 
• Inclusion criteria 
➢ Medical student studying human medicine in Egypt 
➢ Their age ranges from 18 to 27 years old 
➢ Egyptian person 
• Exclusion criteria 
➢ Incomplete data  
➢ Wrong data in the questionnaire 
➢ Students refuse to participate 
 
 

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• Sampling 
We calculated the sample size based on the total medical students in Egypt, which is 121,320, 
according to the Central Agency for Public Mobilization and Statistics (CAPMAS) 2023-
2024(Capmas, n.d.). The expected prevalence of overactive bladder is 50%(Abuorouq et al., 
2024; Shawahna et al., 2021). Using the total sample size, expected prevalence rate, an 80% 
power, 95% confidence interval (95% CI), and a 5% error margin, we calculated the sample size 
via Epi Info version 7.2.60(Epi InfoTM | CDC, n.d.) to become 384, and adding a 10% non-
response rate, the final sample size will be 422 students 
• Sampling techniques: The convenient sampling will be applied in this study 
B. Operational design 
• Pilot study: We will perform a pilot study to assess the readability of the 
questionnaire. We will perform it on 40 students, and any changes in the 
questionnaire will be made. Pilot study data will be excluded from the data 
analysis 
• Study field: an online questionnaire will be shared through social media 
platforms such as WhatsApp, Facebook, or Telegram. 
Data collection method 
Students are required to fill out the online questionnaire. It is divided into three main categories. 
1. Sociodemographic data in which we ask about students’ age, sex, and academic year. 
We also ask about their life risk factors, such as body weight, presence of chronic disease, 
previous surgery, stressful life, and soft drinks(Abuorouq et al., 2024). 
2. Questions about the presence of overactive bladder symptoms.(Coyne et al., 2015) 
The questions are taken from the 6-item ask about the presence of overactive bladder 
symptoms in the past 4 weeks 
This scale consists of 6 items, and each one has  6 available answers that range from not 
at all, which indicates the absence of the symptoms, to a very great deal, which indicates 
the presence of these symptoms. The score of each question ranges from 1 to 6, and the 
total score is 36. A score of 18 or more indicates the presence of the overactive bladder 
symptoms 

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3. Part 3 asks about the quality of life affected by the overactive bladder. This part is taken 
from the quality of life questionnaire part of the Overactive Bladder Symptom and 
Health-Related Quality of Life Short-Form (OAB-q SF)(Coyne et al., 2015). This is a 13-
item questionnaire, each one has 6 answers (None of the time, a little of the time, some of 
the time, A good bite of the time, Most of the time, All of the time). Each question scores 
from 1 to 6, so the total score ranges from 13 to 78 
 
• Statistical analysis 
We will summarize the data first according to its type. Categorical data will be 
summarized into numbers and percentages, while continuous data will be assessed for normality 
first; if it is normally distributed, we will use mean and standard deviation (SD), and if not, 
median and interquartile range will be used (IQR). 
Differential statistics will be conducted via the Mann-Whitney U test. We will assess the 
difference between the baseline data, such as sex, academic year, on the overactive bladder 
prevalence and its effect on quality of life. 
Also, we intended to perform a logistic regression to assess the relation between 
overactive bladder symptoms and quality of life, and the relation between risk factors, such as 
history of UTI, soft drinks, coffee, or tea, on the presence of overactive bladder symptoms. 
All statistics will be conducted using SPSS version 29. 
C. Administrative design 
• Ethical considerations 
➢ The study protocol will be approved by the Institutional Review Board of 
Zagazig University, Faculty of Medicine 
➢ Study participants will be included after informed consent. 
• Confidentiality and data retention 
Data collected will be kept confidential. 
 

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• Risks and benefits of the participants 
There is no cost for this study 
Results 
Collected data will be presented in tables and suitable graphs, and analyzed according to 
standard statistical methods. 
Discussion 
Discussion will be done on the results compared to relevant literature and scientific 
research 
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