Prevalence of Hypothyroidism Among Female Patients With Stress Urinary Incontinence Attending a Tertiary Hospital in Al-Baha, Saudi Arabia: A Retrospective Cross-Sectional Study.

Background Stress urinary incontinence (SUI) is a common pelvic floor disorder with significant physical and psychosocial impacts. Thyroid dysfunction may contribute to SUI by affecting skeletal muscle contractility, neuromuscular transmission, and connective tissue integrity. Limited research exists on this association among Saudi women. This study assessed the prevalence of hypothyroidism and its co-occurrence with clinical and demographic factors in women with clinically diagnosed SUI. Methods This retrospective cross-sectional study reviewed medical records of 288 women aged 20-50 years diagnosed with SUI at King Fahad Hospital, Al-Baha, Saudi Arabia (January 2020 to December 2025). Hypothyroidism was categorized as clinical (thyroid-stimulating hormone (TSH) >4.5 mIU/L with low free T4) or subclinical (TSH >4.5 mIU/L with normal free T4). Chi-square tests assessed associations with BMI, parity, diabetes, and hypertension. Age association was evaluated across three groups (20-29, 30-39, and 40-50 years) and by binary logistic regression. ORs with 95% CIs were calculated; p ≤ 0.05 was considered significant. Results The median age was 41 years (IQR: 12; range: 20-50 years); 54.2% of patients were aged 40-50 years. Hypothyroidism was identified in 136 patients (47.2%): 113 (39.2%) with clinical hypothyroidism and 23 (8.0%) with subclinical hypothyroidism. Significant associations were found with BMI (p = 0.003), parity (p = 0.005), and hypertension (p = 0.020); diabetes showed no significant association (p = 0.774). Hypothyroidism prevalence increased progressively with age: 33.3% (20-29 years), 43.8% (30-39 years), and 51.9% (40-50 years). Logistic regression confirmed a significant positive association between age and hypothyroidism (OR = 1.039 per year, 95% CI: 1.007-1.074, p = 0.019). Conclusions Hypothyroidism was highly prevalent among women with clinically diagnosed SUI and was frequently observed alongside higher BMI, multiparity, hypertension, and advancing age. These findings are hypothesis-generating; prospective interventional studies are needed before formal screening recommendations can be established.