systemic lupus erythematosus (SLE) often progresses to urinary tract disease, fibrosis, and thinning of the bladder, due to the deposition of immune complexes. Therefore, this study aimed to identify the prevalence of LUTS among women with SLE and the relationship between SLE disease activity and LUTS.

This cross-sectional study used structured self-administered questionnaires. We recruited 110 women with SLE from the outpatient clinic of a university hospital between January and August of 2020. LUTS was assessed using the International Prostate Symptom Score (IPSS), and disease activity was assessed using the Systemic Lupus Activity Questionnaire (SLAQ).

Fifty-seven subjects (51.8%) reported urinary incontinence (UI) and no UI (48.2%). The mean LUTS score was 7.75 ± 5.74 (range 0–35). Each seven symptoms score of LUTS (range 0–5) was frequency (1.51 ± 1.48), nocturia (1.46 ± 1.07), urgency (1.27 ± 1.35), incomplete emptying (1.09 ± 1.15), intermittency (0.97 ± 1.27), weak stream (0.94 ± 1.04), and straining (0.51 ± 0.91). LUTS were positively correlated with the disease activity of SLE (r=.48, p=<.001), indicating that the higher LUTS scores showed severe disease activity.

1. Participant characteristics: mean age was 44.74 years. mean body mass index (BMI) was 23.39 kg/m² with 26.4% of the participants having a 25 kg/m² or higher BMI. The mean disease duration was 157.6 months; 44.5% of women had 120 months or less. 48.2% had a comorbid condition. The disease activity mean score was 12.84 ± 8.37.
2. UI and LUTS
Fifty-seven subjects (51.8%) reported UI. The majority of reported types of UI were stress UI (33.6%), mixed UI (16.4%), followed by urge UI (1.8%), and no UI (48.2%). The mean score for LUTS among the women was 7.75 ± 5.74. Each LUTS symptom score was as follows: urinary frequency, 1.51; nocturia, 1.46; urgency, 1.27; and incomplete emptying, 1.09.
3. LUTS based on participant characteristics
There was no statistically significant difference in LUTS according to the characteristics of women with SLE.
4. Association between disease activity and LUTS
The relationship between LUTS and disease activity showed a statistically significant correlation (r = 0.48, p<.001), indicating that the higher the disease activity, the more severe the LUTS.

Our study showed that the prevalence of urinary incontinence in women with SLE was high, and LUTS was predominant in the order of frequency, nocturia, and urgency. The more severe the disease activity, the higher the LUTS. Management to maintain a low level of disease activity owing to SLE is emphasized, which can prevent conditions that may trigger or worsen LUTS. Future studies are required to determine how urinary incontinence and LUTS influence quality of life. In addition, regular examination of urinary function and appropriate management by medical personnel are essential.