Résumé
Introduction and Hypothesis: Female lower urinary tract symptoms (FLUTS) are common but often underrecognized, particularly in low-resource settings such as the Democratic Republic of Congo (DRC). This study was aimed at assessing the prevalence, severity, and associated factors of FLUTS in the DRC. Methods: A community-based cross-sectional study was conducted between 2021 and 2023 across six provinces in the DRC. A total of 507 women (≥ 18 years old) were recruited using a multistage, geographically and ethnolinguistically stratified sampling approach. Pregnant and postpartum women (≤ 6 months), survivors of sexual violence, and those with vesicovaginal fistulas were excluded. Data collection included the International Consultation on Incontinence Questionnaire–Female Lower Urinary Tract Symptoms (ICIQ–FLUTS). Multivariable logistic regression identified risk factors. Results: The prevalence of any FLUTS was 77.3% (95% CI: 73.4–80.9%), with storage symptoms (75.9%) more common than voiding symptoms (8.1%). Nocturia (63.1%), urgency (41.6%), and urgency urinary incontinence (26.8%) were the most common storage symptoms, whereas hesitancy (5.9%) and straining (3%) were the most frequent voiding symptoms. Among women with LUTS, 30.1% reported discomfort, mostly linked to insensible incontinence (100%), stress urinary incontinence (61.1%), and nocturnal enuresis (62.9%). High parity (aOR: 1.09; 95% CI: 1.01–1.19) and a profession involving high-intensity physical activity (aOR: 1.60; 95% CI: 1.01–2.55) were significant risk factors for FLUTS. Conclusion: Lower urinary tract symptoms are highly prevalent among Congolese women, but only a third experience significant discomfort. Targeted interventions are needed to improve awareness, prevention, and management strategies to inform national-health policies and strengthen community-level interventions.