TY - JOUR
T1 - Associations Between U.S. Women’s Toileting Behaviors and Lower Urinary Tract Symptoms
T2 - A Cross-Sectional Analysis of RISE for HEALTH Study Data
AU - Berry, Amanda
AU - Brady, Sonya S.
AU - Burgio, Kathryn L.
AU - Cunningham, Shayna D.
AU - Gahagan, Sheila
AU - James, Aimee S.
AU - Low, Lisa Kane
AU - LaCoursiere, D. Yvette
AU - Lipman, Terri H.
AU - McGwin, Gerald
AU - Mueller, Margaret G.
AU - Palmer, Mary H.
AU - Rodriguez-Ponciano, Dulce P.
AU - Smith, Ariana L.
AU - Sutcliffe, Siobhan
AU - Williams, Beverly R.
AU - Wyman, Jean F.
AU - Newman, Diane K.
N1 - Publisher Copyright:
Copyright 2025, Mary Ann Liebert, Inc., publishers.
PY - 2025/5/1
Y1 - 2025/5/1
N2 - Introduction: Toileting behaviors are recognized as potential contributors to lower urinary tract symptoms (LUTS) in women. This study examines the association between toileting behaviors and LUTS among community-dwelling women and whether age modifies these associations. Methods: Cross-sectional analyses were conducted using baseline data from a population-based cohort study, RISE FOR HEALTH (RISE). Women completed validated questionnaires assessing toileting behaviors (Toileting Behaviors-Women’s Elimination Behaviors scale) and LUTS (10-item Lower Urinary Tract Dysfunction Research Network—Symptom Index [LURN SI-10]). Toileting behaviors included place preference for voiding, premature voiding, delayed voiding, straining to void, and toileting position. LUTS items included urine storage, emptying, and postmicturition symptoms. Associations were analyzed by proportional odds logistic regression. Analyses were stratified by seven age groupings. Results: Data from 2,327 women (mean age 51.1 years, standard deviation = 18.2) were analyzed. Delayed voiding was most strongly associated with the LURN SI-10 composite score (odds ratio [OR] 1.89; 95% confidence interval [CI]: 1.72, 2.09) and urgency incontinence (OR 1.87; 95% CI: 1.66, 2.10). Premature voiding showed the strongest association with urgency (OR 1.82; 95% CI: 1.68, 2.04). Straining was strongly associated with emptying symptoms, including delay before urine starts (OR 2.28; 95% CI: 2.05, 2.54) and slow stream (OR 2.28; 95% CI: 2.05, 2.53). Age modified associations between delayed voiding and LUTS, with strongest associations among 18- to 25 year-old women. Conclusions: Premature voiding, delayed voiding, and straining showed the strongest associations with LUTS in this cross-sectional analysis. Longitudinal studies are needed to clarify the directionality of these associations. Educating young women on healthy toileting habits may mitigate potential effects of unhealthy toileting behaviors on bladder health.
AB - Introduction: Toileting behaviors are recognized as potential contributors to lower urinary tract symptoms (LUTS) in women. This study examines the association between toileting behaviors and LUTS among community-dwelling women and whether age modifies these associations. Methods: Cross-sectional analyses were conducted using baseline data from a population-based cohort study, RISE FOR HEALTH (RISE). Women completed validated questionnaires assessing toileting behaviors (Toileting Behaviors-Women’s Elimination Behaviors scale) and LUTS (10-item Lower Urinary Tract Dysfunction Research Network—Symptom Index [LURN SI-10]). Toileting behaviors included place preference for voiding, premature voiding, delayed voiding, straining to void, and toileting position. LUTS items included urine storage, emptying, and postmicturition symptoms. Associations were analyzed by proportional odds logistic regression. Analyses were stratified by seven age groupings. Results: Data from 2,327 women (mean age 51.1 years, standard deviation = 18.2) were analyzed. Delayed voiding was most strongly associated with the LURN SI-10 composite score (odds ratio [OR] 1.89; 95% confidence interval [CI]: 1.72, 2.09) and urgency incontinence (OR 1.87; 95% CI: 1.66, 2.10). Premature voiding showed the strongest association with urgency (OR 1.82; 95% CI: 1.68, 2.04). Straining was strongly associated with emptying symptoms, including delay before urine starts (OR 2.28; 95% CI: 2.05, 2.54) and slow stream (OR 2.28; 95% CI: 2.05, 2.53). Age modified associations between delayed voiding and LUTS, with strongest associations among 18- to 25 year-old women. Conclusions: Premature voiding, delayed voiding, and straining showed the strongest associations with LUTS in this cross-sectional analysis. Longitudinal studies are needed to clarify the directionality of these associations. Educating young women on healthy toileting habits may mitigate potential effects of unhealthy toileting behaviors on bladder health.
KW - behavioral adaptation
KW - life course
KW - lower urinary tract symptoms
KW - toileting behaviors
KW - women
UR - http://www.scopus.com/inward/record.url?scp=85219557676&partnerID=8YFLogxK
U2 - 10.1089/jwh.2024.0743
DO - 10.1089/jwh.2024.0743
M3 - Article
C2 - 40029194
AN - SCOPUS:85219557676
SN - 1540-9996
VL - 34
SP - 653
EP - 664
JO - Journal of Women's Health
JF - Journal of Women's Health
IS - 5
ER -