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Li Q, Ji X, Zhuo L, Zheng X, Chen C, Zhou F. Impact of Lifestyle on Urinary Incontinence Severity among Women: A Cross-Sectional Study in East China. Int Urogynecol J 2024:10.1007/s00192-024-05839-8. [PMID: 38900163 DOI: 10.1007/s00192-024-05839-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 05/23/2024] [Indexed: 06/21/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Identifying the factors influencing the development of female urinary incontinence (UI) may facilitate early intervention, potentially delaying its progression. This study was aimed at investigating the impact of lifestyle habits on the severity of UI among women in East China. METHODS This study included 414 women from six communities in East China who reported symptoms of UI and was conducted between September and December 2020. Data were collected using a general information questionnaire, the Toileting Behaviours: Women's Elimination Behaviours scale, and the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form Chinese Version. Participants were categorised into two groups: those with mild UI and those with moderate-to-severe UI. Propensity-score matching was performed to balance confounding factors, and logistic regression was used to explore the relationship between lifestyle behaviours and UI severity. RESULTS A total of 117 pairs were successfully matched. Logistic regression analysis revealed that daily perineal cleaning significantly protected against moderate-to-severe UI (p < 0.05). Conversely, living alone, poor sleep quality and hovering over the toilet while voiding were identified as independent risk factors for moderate-to-severe UI (p < 0.05). CONCLUSION Several lifestyle habits significantly impact the severity of UI among adult women. Screening for mild urinary leakage symptoms and implementing timely interventions are crucial for preventing the aggravation of UI and improving ability to work and quality of life.
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Affiliation(s)
- Qianqian Li
- Obstetrics Department, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, Jiangsu, China
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xuan Ji
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Lang Zhuo
- School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xinxin Zheng
- Jiangsu Provincial Xuzhou Pharmaceutical Vocational College, Xuzhou, Jiangsu, China
| | - Cui Chen
- Intensive Care Unit, The Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Fang Zhou
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China.
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2
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Babbar K, Das U, Ashraf S, Shpenev A, Bicchieri C. Unlocking the Role of Social Norms: How They Shape Women's Public Toilet Usage in India. Am J Trop Med Hyg 2023; 109:1177-1186. [PMID: 37917999 PMCID: PMC10622457 DOI: 10.4269/ajtmh.23-0220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/07/2023] [Indexed: 11/04/2023] Open
Abstract
Poor access to toilets has significant impacts on hygiene, health, safety, and well-being. Women in resource-poor areas may not use public toilets because of concerns about personal safety and the disapproval of others. This study examines social beliefs about women's use of public toilets in India, using data from 5,052 households in rural, semi-urban, and urban slum areas of Bihar and Tamil Nadu in 2018. We asked respondents about their beliefs regarding the prevalence of young women aged 16 to 30 years using public toilets alone and whether this behavior was approved of in their community. We also asked about their personal beliefs on this issue. We used hypothetical vignettes to assess perceptions of a young woman's behavior in different settings regarding public toilet usage by women. Our results show that people who believe many women in their community use public toilets alone and approve of it are more likely to have positive beliefs about this behavior. The experimental vignettes suggest a potential causal link between the prevalence and approval of public toilet usage among young women and their likelihood of using it. These findings are consistent across Bihar and Tamil Nadu and the three administrative regions, indicating that interventions aimed at changing social expectations about women's use of public toilets should focus on highlighting community members' usage and approval. Efforts to encourage woman's access to public toilets and services should target shifting beliefs about public toilet usage among women without disapproval from others.
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Affiliation(s)
- Karan Babbar
- Jindal Global Business School, O.P. Jindal Global University, Sonipat, India
| | - Upasak Das
- Center for Social Norms and Behavioral Dynamics, University of Pennsylvania, Philadelphia, Pennsylvania
- Global Development Institute, University of Manchester, Manchester, United Kingdom
| | - Sania Ashraf
- Center for Social Norms and Behavioral Dynamics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alex Shpenev
- Center for Social Norms and Behavioral Dynamics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Cristina Bicchieri
- Center for Social Norms and Behavioral Dynamics, University of Pennsylvania, Philadelphia, Pennsylvania
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3
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Toprak Celenay S, Düşgün ES, Karaaslan Y, Uruş G, Karadag M, Özdemir E. Lower urinary tract symptoms and toileting behaviors in Turkish adult women. Women Health 2023; 63:577-586. [PMID: 37599095 DOI: 10.1080/03630242.2023.2248516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 07/10/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023]
Abstract
This study aimed to investigate lower urinary tract symptoms (LUTS) in Turkish adult women and to compare toileting behaviors in women with and without LUTS. This cross-sectional study was conducted in 815 women. The International Consultation on Incontinence Modular Questionnaire - Female LUTS and a toileting behaviors form, created by the authors, were used in evaluations. Nearly 50 % of the women had at least one LUTS, 45.8 % had storage symptoms, 7.4 % had voiding symptoms, and 20.2 % had incontinence symptoms. The rates of premature urination, straining during urination, delayed urination, and sitting on the toilet while urinating were higher in women with LUTS than in women without LUTS (p < .05). The rate of squatting on the toilet while urinating was lower in women with LUTS than those without LUTS (p < .05). Various LUTS were common in adult women. Some toileting behaviors such as premature urination, straining during urination, delayed urination, and sitting on the toilet while urinating were higher in women with LUTS compared to women without LUTS. Since the rate of unhealthy toilet behaviors is higher in women with LUTS, it is important to know unhealthy toilet behaviors in the management of LUTS and to organize training programs to prevent these behaviors and LUTS.
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Affiliation(s)
- Seyda Toprak Celenay
- Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Elif Sena Düşgün
- Vocational School of Health Services, Department of Physiotherapy, Fenerbahce University, Istanbul, Turkey
| | - Yasemin Karaaslan
- Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Gulcin Uruş
- Çekerek Fuat Oktay Vocational School of Health Services, Department of Health Care Services, Yozgat Bozok University, Yozgat, Turkey
| | - Mehmet Karadag
- Medicine Faculty, Department of Biostatistics, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Enver Özdemir
- Department of Urology, Istanbul Gaziosmanpasa Taksim Training and Research Hospital, Istanbul, Turkey
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4
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Overactive Bladder and the Workplace. CURRENT BLADDER DYSFUNCTION REPORTS 2022. [DOI: 10.1007/s11884-022-00662-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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5
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Nasiri M, Sigaroudi AE, Moghadamnia MT, Leili EK. Lower Urinary Tract Symptoms and Related Factors in Iranian Female Nurses. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2022; 27:280-286. [PMID: 36275339 PMCID: PMC9580568 DOI: 10.4103/ijnmr.ijnmr_126_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/30/2021] [Accepted: 02/23/2022] [Indexed: 11/04/2022]
Abstract
Background Lower Urinary Tract Symptom (LUTS) are common among female nurses. High levels of job stress in nurses may be associated with the prevalence of these symptoms. This study aimed to investigate the prevalence of LUTS and factors related to these symptoms in female nurses. Materials and Methods A cross-sectional study in which 460 nurses and nursing assistants participated was conducted. A questionnaire consisting of socio-demographic data, International Consultation on Incontinence Questionnaire - Female Lower Urinary Tract Symptoms, and Toileting Behavior - Women's Elimination Behavior Scale was used. Data analysis was performed by descriptive and inferential statistical tests at a significant level of p < 0.05. Results The highest and lowest scores of LUTS were related to the urgency and nocturnal enuresis with a mean (SD) score of 1.85 (1.03) and 0.05 (0.26), respectively. Concerning toileting behaviors, the highest score was for the place preference for voiding with a mean (SD) score of 4.13 (0.66), which correlated with LUTS. Among controllable variables, years of practice, urinary tract infections, use of perineal pads for urinary leakage, lifting heavy objects at work, and medical history were identified as predictors of LUTS (p < 0.05). Conclusions LUTS was highly prevalent in the female nurses. The results revealed that unhealthy toileting behaviors may contribute to the prevalence of LUTS. Early identification of these symptoms and the development of an educational intervention program to enhance the knowledge of healthy toileting behaviors may prevent the occurrence of urinary symptoms.
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Affiliation(s)
- Maryam Nasiri
- Department of Nursing(Health), School of Nursing & Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Abdolhosein Emami Sigaroudi
- Associate Professor, Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran, Department of Nursing (Health), School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran,Address for correspondence: Dr. Abdolhosein Emami Sigaroudi, Associate Professor, Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran, Department of Nursing(Health), School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran. E-mail:
| | - Mohammad Taghi Moghadamnia
- Associate Professor, Department of Nursing (Medical-Surgical), School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Kazemnezhad Leili
- Associate Professor, Department of Bio-Statistics, Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran
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Huffman PJ, Yin E, Cohen AJ. Evaluating Patient Preferences in Benign Prostatic Hyperplasia Treatment Using Conjoint Analysis. Urology 2022; 164:211-217. [PMID: 35063462 DOI: 10.1016/j.urology.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/17/2021] [Accepted: 01/09/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To quantify BPH patient preferences to promote guidelines-compliant, patient-centered care. Discordance between patient and urologist priorities for the treatment of benign prostatic hyperplasia (BPH) hinders patient-centered care. Physician assumptions regarding patient preferences lead to dissatisfied patients; a poor outcome in any quality of life surgery. American Urologic Association guidelines urge urologists to consider patient preferences when recommending a BPH treatment. METHODS In this cross-sectional, online survey study using researchmatch.org, participants were required to decide between theoretical BPH treatments in a balanced, choice-based conjoint analysis. The treatments had varying levels of four attributes: efficacy, recovery difficulty, risk of complications (Clavien-Dindo 2+), and risk of de novo ejaculatory dysfunction. Demographic information and International Prostate Symptom Score (IPSS) were collected and analyzed using comparative statistics. Each attribute was analyzed using a conditional logit model, and attribute importance (range in utility between attribute-levels) was calculated. RESULTS Out of 1235 recruited participants, 812 (66%) completed the study. Median IPSS and age was 6 (IQR 3-12) and 56 (IQR 38-67), respectively. Complication risk was the most important attribute, followed by efficacy, recovery difficulty, and risk of ejaculatory dysfunction. In a subgroup analysis of age quartiles, participants age <38 and >67 held efficacy (31%) and complication risk (47%) to the highest relative importance, respectively. CONCLUSIONS Males valued BPH treatments that minimize complication risks, while ejaculatory dysfunction was least impactful. Variation in results between age subgroups emphasizes the need for individualized care to maximize patient satisfaction.
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Affiliation(s)
- Phillip J Huffman
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Edward Yin
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Andrew J Cohen
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
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7
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Newman DK, Burgio KL, Cain C, Hebert-Beirne J, Low LK, Palmer MH, Smith AL, Rickey L, Rudser K, Gahagan S, Harlow BL, James AS, Lacoursiere DY, Hardacker CT, Wyman JF. Toileting behaviors and lower urinary tract symptoms: A cross-sectional study of diverse women in the United States. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2021; 3. [DOI: 10.1016/j.ijnsa.2021.100052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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8
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Haris PI, Illingworth P. Installing public handwashing facilities and integrating them with water fountains to reduce plastic pollution and prevent spread of infections. Perspect Public Health 2021; 141:263-265. [PMID: 34431389 DOI: 10.1177/17579139211002221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- P I Haris
- De Montfort University, The Gateway, Leicester LE1 9BH, UK
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Hartigan S, Finn M, Dmochowski R, Reynolds WS. Real-time daily assessment of work interference on healthcare professionals' restroom use: A pilot study. Neurourol Urodyn 2021; 40:728-734. [PMID: 33616293 DOI: 10.1002/nau.24603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/16/2020] [Accepted: 12/17/2020] [Indexed: 12/31/2022]
Abstract
AIMS Certain occupations may predispose individuals to develop lower urinary tract symptoms presumably through the adoption of unhealthy toileting behaviors. This study aimed to pilot the feasibility of recording healthcare workers' perceptions of daily, work-related interference with toilet use using a cellular, text-based survey tool. METHODS A cohort study of adult healthcare professionals completed a baseline questionnaire, a daily survey for fourteen consecutive days regarding their restroom use for the current workday, and a posttest survey providing feedback on study design and participation. Contributors to daily toilet use were analyzed in a linear mixed effects model that allowed for modeling effects within a given day. A backward stepwise regression was performed to assess for the presence of the effect of toilet use among control variables. RESULTS Increased work burden (i.e., increased inconvenience for using the restroom at work) was provisionally found to be associated with fewer voids per day. The number of voids at work was also associated with the number of breaks, urinary urgency, and limiting fluids. Subjects reported that participation in the study was easy, did not interfere with work, and that they would be willing to participate again in a similar study. CONCLUSION The utilization of a daily text message survey is a feasible way to study healthcare workers and their toileting behaviors at work. A larger similarly designed study could potentially confirm that limitations to restroom use may result in toileting behaviors that could predispose healthcare workers to develop bothersome urinary symptoms. Further investigation is warranted.
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Affiliation(s)
| | - Michael Finn
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Roger Dmochowski
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - W Stuart Reynolds
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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10
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Chen YL, Sari RK, Liao YH, Lin WC. Optimal Span between Feet of Public Squat Toilet Based on Anthropometric Data and Squatting Stability Assessment. Healthcare (Basel) 2021; 9:healthcare9010042. [PMID: 33466362 PMCID: PMC7824858 DOI: 10.3390/healthcare9010042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 12/31/2020] [Accepted: 01/02/2021] [Indexed: 12/02/2022] Open
Abstract
Sitting toilets are preferred globally because they afford a relatively comfortable posture. However, squat toilets are among the most common toilets in numerous public areas because of their advantages, including personal hygiene, easy cleaning, and health benefits. This study attempted to determine optimal toilet design parameters and recruited 50 Taiwanese and 50 Southeast Asian women and collected span between feet (SBF) data for participants squatting in their most comfortable posture, and also surveyed maximum outer width (MOW) data of 28 public squat toilets in Taipei. Finally, we compared the squatting stability levels of 40 female participants (20 Taiwanese and 20 Southeast Asians) who squatted for 2 min at comfortable SBF and MOW-based SBF values. The results revealed that the minimum and maximum SBFs of Taiwanese were 14.52 cm and 18.40 cm, and that of Southeast Asians were 15.64 cm and 20.40 cm, respectively. No significant difference was observed in the SBFs between the two groups was observed. The mean (range) MOW of the surveyed toilets was 27.7 (27–29) cm. Analysis of variance results showed no difference in stability between the two SBFs. This implies that the comfortable SBF (i.e., 16 cm between the participants’ heels) was narrower than the MOW, as commonly used, indicating that the comfortable SBF can be considered as an optimal toilet width parameter because of its constant stability.
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Affiliation(s)
- Yi-Lang Chen
- Department of Industrial Engineering and Management, Ming Chi University of Technology, New Taipei 24301, Taiwan; (R.K.S.); (Y.-H.L.); (W.-C.L.)
- Department of Industrial Design, Chang Gung University, Touyuan 33302, Taiwan
- Correspondence:
| | - Resy Kumala Sari
- Department of Industrial Engineering and Management, Ming Chi University of Technology, New Taipei 24301, Taiwan; (R.K.S.); (Y.-H.L.); (W.-C.L.)
- Program Study of Industrial Engineering, Universitas Pahlawan Tuanku Tambusai, Riau 28412, Indonesia
| | - Ying-Hua Liao
- Department of Industrial Engineering and Management, Ming Chi University of Technology, New Taipei 24301, Taiwan; (R.K.S.); (Y.-H.L.); (W.-C.L.)
| | - Wei-Cheng Lin
- Department of Industrial Engineering and Management, Ming Chi University of Technology, New Taipei 24301, Taiwan; (R.K.S.); (Y.-H.L.); (W.-C.L.)
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11
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Reynolds WS, Kowalik C, Kaufman MR, Dmochowski RR, Fowke JH. Women's Perceptions of Public Restrooms and the Relationships with Toileting Behaviors and Bladder Symptoms: A Cross-Sectional Study. J Urol 2020; 204:310-315. [PMID: 32096679 PMCID: PMC7354199 DOI: 10.1097/ju.0000000000000812] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Because current knowledge about public restroom use and bladder health is limited, we sought to identify why women avoid public restrooms and the associations of lower urinary tract symptoms and toileting behaviors. MATERIALS AND METHODS Between October and December 2017 we recruited a convenience sample of U.S. women to complete a cross-sectional, anonymous questionnaire about public restroom use, lower urinary tract symptoms (International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms [ICIQ-FLUTS]) and toileting behavior (Web-Based Toileting Behavior [TB-WEB]). We compared women who reported limiting public restroom use all or most of the time to those who did not limit or did so occasionally or sometimes. RESULTS Of the 6,004 women in the study 26% limited public restroom use most or all of the time and were more concerned with cleanliness than those who did not limit public restroom use. They also reported more often using nonsitting positions when away from home and holding urine to avoid public restrooms, higher ICIQ-FLUTS scores, more frequent overactive bladder and fewer than 7 voids a day. CONCLUSIONS A large number of women reported avoiding public restrooms, often over concerns of cleanliness, availability of amenities and privacy. Women who habitually limit public restroom use more frequently reported unhealthy toilet behaviors and lower urinary tract conditions. These findings will help guide future research and inform public policy and bladder health awareness.
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Affiliation(s)
- W Stuart Reynolds
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Casey Kowalik
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Melissa R Kaufman
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Roger R Dmochowski
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jay H Fowke
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas
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12
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Kowalik CG, Daily A, Goodridge SD, Hartigan SM, Kaufman MR, Fowke JH, Dmochowski RR, Reynolds WS. Factors associated with urinary incontinence in a community sample of young nulligravid women. Neurourol Urodyn 2020; 39:1430-1436. [PMID: 32324941 DOI: 10.1002/nau.24368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/30/2020] [Accepted: 04/13/2020] [Indexed: 12/17/2022]
Abstract
AIMS The aim of this study is to identify factors associated with urinary incontinence (UI) in a community sample of young nulligravid women. METHODS This was a secondary analysis from a cross-sectional survey-based study of cisgender women aged 18 to 25 years recruited through a national registry of research volunteers. Participants completed validated questionnaires assessing toileting behaviors, lower urinary tract symptoms (LUTS), and bowel symptoms. Women were excluded from analysis if currently pregnant, any prior pregnancy, cystectomy, or any neurologic disease including spinal cord injury, stroke, or multiple sclerosis. Analyses determined the prevalence of symptoms and evaluated candidate risk factors for UI. RESULTS Final analyses included 964 women (mean age, 22.6 ± 2.0). Monthly UI was identified in 295 (30.6%) subjects, with mixed UI being the most common (56.9%; n = 168). Seventy-two women (7.4%) reported fecal incontinence (FI) and 24 (3.5%) women reported both UI and FI. After multivariable regression modeling, UI was associated with an intermittent urine stream and the delayed voiding toileting behavior subscale. CONCLUSIONS UI in this cohort of young nulliparous women was highly prevalent and warrants further study as to the cause. Therapeutic guidelines to prevent UI and LUTS may need to be adjusted by targeting populations earlier than traditionally considered.
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Affiliation(s)
- Casey G Kowalik
- Department of Urology, University of Kansas Health System, Kansas City, Kansas
| | - Adam Daily
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sophia D Goodridge
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Siobhan M Hartigan
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Melissa R Kaufman
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jay H Fowke
- Department of Preventative Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Roger R Dmochowski
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - William S Reynolds
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
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13
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Why Do Women Not Use the Bathroom? Women's Attitudes and Beliefs on Using Public Restrooms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062053. [PMID: 32244871 PMCID: PMC7142493 DOI: 10.3390/ijerph17062053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/09/2020] [Accepted: 03/17/2020] [Indexed: 12/18/2022]
Abstract
There are a variety of factors and influences, both internal and external, that may impact an individual’s public toileting experience and may ultimately have repercussions for bladder health. This study sought to identify predominant constructs underlying a women’s attitude towards using restrooms at work, at school, and in public in order to develop a conceptual model incorporating these themes. We performed a secondary analysis of a cross-sectional, survey-based study that included open-ended questions about limitations to restroom use using a mixed-methods approach. Qualitative data coding and analysis was performed on 12,583 quotes and, using an iterative inductive-deductive approach, was used to construct the conceptual framework. Our conceptual framework reveals a complicated interplay of personal contexts, situational influences, and behavioral strategies used by women to manage their bladder and bowel habits away from home. These findings can inform future research and public policy related to bladder health awareness related to toilet access in the workplace and in public.
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14
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Wu C, Xue K, Palmer MH. Toileting Behaviors Related to Urination in Women: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16204000. [PMID: 31635040 PMCID: PMC6843934 DOI: 10.3390/ijerph16204000] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 01/09/2023]
Abstract
This scoping review explores the state of science regarding women’s toileting behaviors, gaps in knowledge, and areas for future research. Online databases were searched to identify papers published in English between January 2010 through July 2019; the search identified 25 articles. The Toileting Behaviors–Women’s Elimination Behaviors scale has been published in four validated language versions and used in 17 of the 25 studies. The most frequent behaviors include concern about public toilet cleanliness, delaying urination when busy or away from home, and using different toileting postures at and away from home. Determinants of toileting behaviors include environmental factors, chronic health conditions, and cognitive/psychological factors. Associations were found between toileting behaviors and lower urinary tract symptoms and between toileting postures and uroflowmetric parameters and post-void residual volume. Strategies that address modifiable determinants of toileting behaviors should be developed and tested in future research. Furthermore, little is known about the toileting behaviors and bladder health in older women and women from developing countries. Rigorous studies are needed to better understand the underlying mechanisms of toileting behaviors, the nature of associations between toileting behaviors and lower urinary tract symptoms, and effects of the environment on women’s toileting behaviors.
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Affiliation(s)
- Chen Wu
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Kaikai Xue
- School of Nursing, Xuzhou Medical University, Xuzhou 221000, China.
| | - Mary H Palmer
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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15
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Toileting Behaviors and Bladder Symptoms in Women Who Limit Restroom Use at Work: A Cross-Sectional Study. J Urol 2019; 202:1008-1014. [PMID: 31059664 DOI: 10.1097/ju.0000000000000315] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE While lower urinary tract symptoms and bladder behaviors are known to be associated with certain occupations, little is known about restroom access or environmental factors which may contribute to this relationship. We aimed to characterize reasons that women limit restroom use at work. We also sought to determine whether women who limit use at work report more unhealthy bladder habits and lower urinary tract symptoms. MATERIALS AND METHODS We performed a cross-sectional study of full-time working women in the United States. Women completed validated questionnaires recording toileting behaviors, lower urinary tract symptoms and perceptions of the occupational toilet environment. We compared women who limited restroom use at work most or all of the time to those who did not limit or did so occasionally or sometimes. RESULTS Of the 3,062 women in the final analytical sample 11% reported limiting restroom use at work most or all of the time. This group reported lower satisfaction with restroom cleanliness and privacy in particular. They more frequently identified toilet factors of poor quality, limited accessibility and restricted use by employer. The prevalence of unhealthy bladder habits was significantly higher among women who limited restroom use, as was the prevalence of urgency, monthly urinary incontinence and infrequent voiding. CONCLUSIONS In this cross-sectional study of women working full time those who limited restroom use at work reported a higher prevalence of unhealthy bladder habits and certain urinary disorders. Future studies should determine whether limited restroom use at work is a modifiable risk factor for unhealthy bladder habits and bladder health outcomes.
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Daily AM, Kowalik CG, Delpe SD, Kaufman MR, Dmochowski RR, Reynolds WS. Women With Overactive Bladder Exhibit More Unhealthy Toileting Behaviors: A Cross-sectional Study. Urology 2019; 134:97-102. [PMID: 31499079 DOI: 10.1016/j.urology.2019.08.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/26/2019] [Accepted: 08/26/2019] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To determine whether women overactive bladder symptoms would report more frequent unhealthy toileting behaviors. METHODS A community-based sample of adult women was electronically recruited to complete the Toileting Behavior Scale and the International Consultation on Incontinence Questionnaire - Overactive Bladder module, as well as clinical and demographic questionnaires. The associations between overactive bladder and toileting behavior subscales were assessed as continuous variables using Spearman's rank correlation and as dichotomous variables with multivariable logistic regression. RESULTS Of the 6562 adult women included in the analytic sample, 1059 (16.1%) were classified as having overactive bladder. Of the toileting behavior subscales, convenience voiding had the highest, positive association with overactive bladder score (r = 0.301, P < .0001). On multivariable logistic regression, women with overactive bladder (OAB) were more likely to report behaviors of convenience voiding (odds ratio [OR] 1.13, confidence intervals [CI] 1.11-1.15), delayed voiding (OR 1.05, CI 1.02-1.08), straining to void (OR 1.05, CI 1.03-1.07), and position preference (OR 1.13, CI 1.08-1.18). CONCLUSION OAB symptoms were associated with specific toileting behaviors of convenience voiding, delayed voiding, straining to void, and position preference. Further investigation is needed to determine if toileting behaviors are a risk factor for OAB or a compensatory adaptation to mitigate symptoms.
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Affiliation(s)
| | | | - Sophia D Delpe
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN
| | - Melissa R Kaufman
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN
| | - Roger R Dmochowski
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN
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Toileting behaviors and factors associated with urinary incontinence in college-aged female students in China. Int Urogynecol J 2019; 31:961-971. [PMID: 31289874 DOI: 10.1007/s00192-019-04043-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 06/26/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary incontinence (UI) is prevalent among women, including young women (18-30 years old). This article aims to explore the prevalence of UI, as well as toileting behaviors and other factors that are associated with UI, in female college students in central China. METHODS We used convenience sampling to recruit 1000 students from five institutions of higher education. We distributed pencil-and-paper questionnaires to obtain demographic, environmental, and general health information, including whether UI was present or not, and information regarding toileting behaviors used by the respondents. RESULTS Most students, n = 929, responded to the questionnaire. Their ages ranged from 18 to 26 years old (average: 20.5 ± 1.6); 23.6% of these respondents reported UI, 52.7% often/always worried about public toilet cleanliness, and 25.3% often/always delayed emptying their bladder when they were busy. Respondents who were between 21 and 26 years old had a lower probability of UI (odds ratio [OR] = 0.867 and 95% confidence interval [CI] = 0.771-0.975) than younger respondents (18-21 years old). Respondents who reported constipation (OR = 2.395, 95% CI = 1.494-3.839), drank alcohol (OR = 1.763, 95% CI = 1.114-2.792), often/always delayed urination (OR = 1.738, 95% CI = 1.306-2.313), and/or often/always strained to urinate (OR = 1.433, 95% CI = 1.111-1.849) had greater odds of having UI than respondents who did not have constipation or engage in these behaviors. CONCLUSIONS UI is prevalent in young Chinese women who are attending college. These women should be asked and given culturally appropriate information about UI and associated factors that include toileting behaviors.
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