Comprehensive assessment of holding urine as a behavioral risk factor for UTI in women and reasons for delayed voiding

Jagtap, Sharmili; Harikumar, S.; Vinayagamoorthy, V.; Mukhopadhyay, Sambit; Dongre, Amol R

doi:10.1186/s12879-022-07501-4

Cited by 17 publications

(17 citation statements)

References 38 publications

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“… 24 This study showed the link between holding urine on several occasions and UTIs and supported the conclusions drawn by several other observational studies, stating “any delay in voiding increases the risk of UTI in adolescents and young adult women”. 25 , 26 The finding supports the hypothesis that if a woman delays urination by holding urine regularly for various reasons, it increases her chances of suffering from UTI multifold. The finding suggests the timely voiding or urination in peri- and postmenopausal women to prevent UTIs, as indicated in previously published guidelines.…”

Section: Discussionsupporting

confidence: 75%

Community-Acquired Urinary Tract Infection Among Sexually Active Women: Risk Factors, Bacterial Profile and Their Antimicrobial Susceptibility Patterns, Arba Minch, Southern Ethiopia

Seid¹,

Markos²,

Aklilu³

et al. 2023

IDR

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Background Globally, urinary tract infections (UTIs) are a common health issue among women. Investigating risk factors associated with culture-proven UTIs and the antimicrobial resistance profile of uropathogens would provide insight into planning prevention and control measures. Objective To identify the risk factors associated with UTIs among sexually active women and determine antimicrobial susceptibility patterns of uropathogenic bacterial isolates. Methods A case-control study was conducted from February to June 2021, involving 296 women (62 case group and 234 control group in a ratio of 4:1). Cases were defined as culture-confirmed UTIs, and controls were non-UTIs. A semi-structured questionnaire was used to collect demographic, clinical, and behavioral data. The antimicrobial susceptibility test was done by the Kirby-Bauer disc diffusion method. The data were analyzed using SPSS version 25. Bivariable and multivariable logistic regressions were used to identify risk factors, and the strength of association was measured by adjusted odds ratios and a 95% confidence interval used at P-values < 0.05. Results The results revealed that recent coitus and frequency of coitus more than three times per week (P=0.001) were independent predictors of UTIs. Swabbing from back to front, a history of UTI and a delay in voiding were also independent predictors (P < 0.05). On the other hand, a daily water intake of 1 to 2 litres reduced the risk of UTI (P= 0.001). The predominant uropathogenic isolate was Escherichia coli (35.48%). Over 60% of isolates were resistant to cotrimoxazole, penicillin, cephalosporin, and fluoroquinolones. The most effective antibiotics included piperacillin-tazobactam, aminoglycosides, carbapenem, and nitrofurantoin. 85% and 50% of isolates were MDR and ESBL producers, respectively. Conclusion The finding indicates the importance of public intervention targeting the identified risk factors and the resistance phenotype to reduce the burden of UTIs with antimicrobial resistance in the study area.

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Section: Discussionsupporting

confidence: 75%

Community-Acquired Urinary Tract Infection Among Sexually Active Women: Risk Factors, Bacterial Profile and Their Antimicrobial Susceptibility Patterns, Arba Minch, Southern Ethiopia

Seid¹,

Markos²,

Aklilu³

et al. 2023

IDR

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“…Since then, many studies have demonstrated a possible association between menstrual hygiene management practices and urinary or reproductive tract infections [ 3 , 12 , 13 ]. In a previous study, approximately 40% of women with UTI self-reported that they had UTI signs after menstruation [ 4 ]. Contaminated vaginal discharges and/or the changed vaginal microbiome during the menstruation period may underlie these findings [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Urinary tract infection (UTI) is known to have various risk factors and predisposing conditions, such as diabetes mellitus, sexual intercourse, menstrual hygiene, holding urine for a long time, dehydration, and urinary incontinence [1][2][3][4][5][6]. UTI is known to occur several times more frequently in women than in men, with a supposed lifetime incidence of more than 50% in women [7,8].…”

Section: Introductionmentioning

confidence: 99%

Post-Toilet Wiping Style Is Associated With the Risk of Urinary Tract Infection in Women

Akaishi

2024

Cureus

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Introduction: Urinary tract infection (UTI) has a lifetime incidence of ≥50% in women. A wide variety of clinical, physiological, and lifestyle risk factors for UTI have been identified, but the exact relationship between post-toilet anal and perineal hygiene practices, especially the wiping direction with toilet paper, and UTI risks has not been investigated yet. Therefore, this study cross-sectionally investigated the posttoilet wiping habit and lifetime UTI events in the general population.Methods: Individuals who visited two hospitals in Japan between April 2020 and March 2023 were initially recruited. Self-reported questionnaires regarding post-toilet wiping habits and past UTI events were collected, and their relationship was investigated in males and females. Subgroup analyses by age were further performed to estimate the impact of age on the relationship.Results: A total of 294 individuals (141 males and 153 females) agreed to participate and answered the question of post-toilet wiping direction. The number of individuals with post-toilet wiping with the arm from the front between the legs was 32 (23%) in males and 68 (44%) in females. The lifetime UTI events were more frequent in females than in males (p<0.0001). The impact of post-toilet wiping with the arm from the front between the legs on UTI events, adjusting for the age and history of diabetes mellitus, was not statistically significant both in males and females (p≥0.10 for both). Meanwhile, when the relationship was evaluated by different age groups, wiping habits from the front and UTI were significantly associated with each other in middle-aged women aged 40-59, whereas they were not in younger and older age groups.Conclusion: Approximately 40-50% of women performed post-toilet wiping with the arm from the front between the legs. This post-toilet wiping habit was suggested to be a potential risk of UTI in women, especially in middle-aged subgroups, and may be better to be changed to wiping from behind.

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“…Holding urine for a long time has proven to be an important risk factor, and among the different reasons for holding urine, holding due to the poor sanitary condition of public toilets was the most common. The higher frequency of self-reported UTIs is related to the holding of urine, behavioral features, and attitudes of women [ 22 ]. Notably, the use of Western toilets and exposure to unsanitary public facilities were also significantly associated with increased UTI prevalence [ 15 ].…”

Section: Reviewmentioning

confidence: 99%

“…The synthesis of these findings points to an urgent need for multifaceted public health initiatives and clinical interventions that prioritize sanitation, hydration, hygiene, and awareness of sexual health practices [ 22 ]. Such initiatives are critical in not only preventing UTIs but also in mitigating their broader impacts on women's health and well-being.…”

Section: Reviewmentioning

confidence: 99%

Correlates of Urinary Tract Infections Among Women of Reproductive Age in India: A Systematic Review

Mavi,

Rathi,

Shannawaz

et al. 2024

Cureus

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Urinary tract infections (UTIs) are a significant health concern globally, with a pronounced impact on women's health in India. This systematic literature review aims to elucidate the factors associated with UTIs among women of reproductive age in India and focus on demographic, behavioral, and physiological factors to inform targeted public health and clinical interventions. A systematic literature search was conducted on PubMed and Google Scholar using specific MeSH terms and preferred reporting items for systematic literature reviews and meta-analyses (PRISMA) guidelines to investigate the correlates of UTIs among Indian women. Studies were selected based on their relevance to the correlates of UTIs among Indian women, including risk factors, prevention strategies, and treatment outcomes. The review identified a significant prevalence of UTIs among pregnant women, with Escherichia coli being the most common causative agent. Younger women, particularly those pregnant, were found to be at a higher risk, likely due to physiological changes during pregnancy and increased sexual activity. Behavioral and lifestyle factors, such as inadequate water intake and poor sanitation practices, were strongly associated with increased risks for UTIs. Factors that increase the risk of UTIs in women include frequent sexual activity, involvement with a new sexual partner, spermicide use that can potentially alter vaginal pH and impact its bacterial composition, and vulvovaginal atrophy. Additionally, nearly 60% of women globally with recurrent UTIs experienced sexual dysfunction, indicating the broader implications of UTIs on women's sexual health and quality of life. UTIs among women in India are influenced by a complex interplay of factors. There is a critical need for enhanced public health initiatives focusing on sanitation, hydration, and hygiene, alongside holistic clinical management strategies that address both the infection and its broader health impacts. Future research should aim at developing innovative prevention and treatment strategies, with a particular focus on high-risk groups such as pregnant women, to mitigate the burden of UTIs in India.

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Comprehensive assessment of holding urine as a behavioral risk factor for UTI in women and reasons for delayed voiding

Cited by 17 publications

References 38 publications

Community-Acquired Urinary Tract Infection Among Sexually Active Women: Risk Factors, Bacterial Profile and Their Antimicrobial Susceptibility Patterns, Arba Minch, Southern Ethiopia

Community-Acquired Urinary Tract Infection Among Sexually Active Women: Risk Factors, Bacterial Profile and Their Antimicrobial Susceptibility Patterns, Arba Minch, Southern Ethiopia

Post-Toilet Wiping Style Is Associated With the Risk of Urinary Tract Infection in Women

Correlates of Urinary Tract Infections Among Women of Reproductive Age in India: A Systematic Review

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