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Overactive bladder syndrome in nulliparous female university students: prevalence and risk factors including waterpipe smoking


Introduction and hypothesis

The objective was to assess the prevalence of symptoms of overactive bladder syndrome (OAB) among healthy nulliparous female university students, and to evaluate the correlation of these symptoms with a variety of factors, including waterpipe (WP) smoking.


This is a cross-sectional study. A questionnaire was administered to evaluate symptoms of OAB in healthy nulliparous female university students. Variables assessed included body mass index (BMI), cigarette smoking, WP smoking, consumption of alcohol, coffee, and tea with and without artificial sweeteners, soft drinks, and energy drinks. Adjusted odds ratio were calculated to determine the correlation of these variables with OAB symptoms.


A total of 767 out of 2,900 females responded to the questionnaire. Bothersome frequency was reported in 32.3%, and nocturia in 47.5% of the women. Urgency and urgency urinary incontinence (UUI) were present in 25.5 and 24.7% of the study participants respectively. Urgency was associated with WP smoking (p value 0.048). Bothersome frequency was associated with artificial sweeteners used with coffee and tea (p value 0.013). UUI was associated with cigarette smoking (p value 0.034) and elevated BMI (p value < 0.001). OAB symptoms were not found to be significantly associated with soft drink and energy drink consumption. A lower prevalence of nocturia (p value 0.009) and urgency was associated with alcohol consumption (p value 0.017). More than two-thirds (69.2%) of WP smokers expressed readiness to decrease WP smoking if this would improve their lower urinary tract symptoms (LUTS).


Overactive bladder is common in healthy young nulliparous women and is associated with multiple risk factors, including WP smoking.

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Authors and Affiliations



R. Hajjar: data analysis, manuscript writing; I. Tsolakian: project development, data analysis; M. Chaaya: project development, critical revision, and questionnaire design; A. Daher: data collection. T. Bazi: project development, manuscript revision and editing.

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Correspondence to Tony Bazi.

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Appendix 1

Appendix 1

Structured questionnaire

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Hajjar, R., Tsolakian, I., Chaaya, M. et al. Overactive bladder syndrome in nulliparous female university students: prevalence and risk factors including waterpipe smoking. Int Urogynecol J 33, 1207–1223 (2022).

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  • Smoking
  • Lower urinary tract symptoms
  • Overactive bladder
  • Waterpipe smoking
  • Artificial sweeteners
  • Hookah