Toileting behaviors and lower urinary tract symptoms: A cross-sectional study of diverse women in the United States

Newman, Diane K.; Burgio, Kathryn L.; Cain, Charles; Hebert‐Beirne, Jeni; Low, Lisa Kane; Palmer, Mary H.; Smith, Ariana L.; Rickey, Leslie; Rudser, Kyle; Gahagan, Shelia; Harlow, Bernard L.; James, Aimee S.; LaCoursiere, D. Yvette; Hardacker, Cecilia T.; Wyman, Jean F.

doi:10.1016/j.ijnsa.2021.100052

Cited by 10 publications

(9 citation statements)

References 37 publications

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“…Our study did not adjust for these variables. Finally, recent research has suggested that the social context and lived experiences that affect toileting behaviors, including suboptimal toileting environments (e.g., toilets that are not safe or accessible), may be more critical than the biological construct of bladder function and may explain racial differences (Newman et al, 2021). Exploring factors that influence toileting decisions might reveal reasons for racial/ ethnic differences in urination frequencies.…”

Section: Discussionmentioning

confidence: 99%

Urination Frequency Ranges in Healthy Women

et al. 2022

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Background: Limited information on the normal range of urination frequencies in women is available to guide bladder health promotion efforts.Objectives: This study used data from the Boston Area Community Health (BACH) Survey to (a) estimate normative reference ranges in daytime and nighttime urination frequencies in healthy women based on two operational definitions of "healthy" and (b) compare urination frequencies by age, race/ethnicity, and fluid intake.Methods: A secondary analysis of cross-sectional interview data collected from female participants was performed using less restrictive ("healthy") and strict ("elite healthy") inclusion criteria. All analyses were weighted to account for the BACH sampling design. Normative reference values corresponding to the middle 95% of the distribution of daytime and nighttime urination frequencies were calculated overall and stratified by age, race/ethnicity, and fluid intake. Generalized linear regression with a log-link was used to estimate rate ratios of daytime and nighttime urination frequencies by age, race/ethnicity, and fluid intake.Results: Of the 2,534 women who completed the BACH follow-up interviews, 1,505 women met healthy eligibility criteria, and 300 met elite healthy criteria. Overall, reference ranges for urination frequencies were 2-10 times/day and 0-4 times/night in healthy women and 2-9 times/day and 0-2 times/night in elite healthy women. Women ages 45-64 years, but not 65+ years, reported a greater number of daytime urination than those aged 31-44 years, whereas women 65+ years reported a greater number of nighttime urination. Black women reported fewer daytime urination and more nighttime urinations than White women. Women who consumed less than 49 oz daily reported fewer daytime and nighttime urinations than those who drank 50-74 oz; drinking 75+ oz had only a small effect on urination frequencies.Discussion: Normative reference values for daytime and nighttime urination frequencies were similar in women using strict and relaxed definitions of health. These results indicate a wide range of "normal" urination frequencies, with some differences by age, race/ethnicity, and fluid intake. Future research is needed to examine urination frequencies in minority women and whether fluid intake amount and type influence the development of lower urinary tract symptoms.

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Section: Discussionmentioning

confidence: 99%

Urination Frequency Ranges in Healthy Women

et al. 2022

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“…Lastly, cognitive interviewing, an iterative process aimed to evaluate the survey items using a think-aloud method and verbal probing, was conducted to assure participants interpreted remaining items in the pool as intended. [31][32][33] The working group reviewed the e-panel survey items and prioritized those that were advanced to interviews. Thirty-one women aged 18 and above were recruited from the four PLUS sites where IRB approval was obtained.…”

Section: Cognitive Interview Methodsmentioning

confidence: 99%

Development of a tool to assess bladder health knowledge, attitudes, and beliefs (BH‐KAB)

LaCoursiere

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Putnam

et al. 2023

Neurourology and Urodynamics

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Introduction Few instruments measure knowledge, attitudes, and beliefs (KAB) related to bladder health. Existing questionnaires have predominantly focused on KAB related to specific conditions such as urinary incontinence, overactive bladder, and other pelvic floor disorders. To address this literature gap, the Prevention of Lower Urinary Tract Symptoms (PLUS) research consortium developed an instrument that is being administered in the baseline assessment of the PLUS RISE FOR HEALTH longitudinal study. Methods The bladder health knowledge, attitudes, and beliefs (BH‐KAB) instrument development process consisted of two phases, item development and evaluation. Item development was guided by a conceptual framework, review of existing KAB instruments, and a review of qualitative data from the PLUS consortium Study of Habits, Attitudes, Realities, and Experiences (SHARE). Evaluation comprised three methods to assess content validity and reduce and refine items: q‐sort, e‐panel survey, and cognitive interviews. Results The final 18‐item BH‐KAB instrument assesses self‐reported bladder knowledge; perceptions of bladder function, anatomy, and related medical conditions; attitudes toward different patterns of fluid intake, voiding, and nocturia; the potential to prevent or treat urinary tract infections and incontinence; and the impact of pregnancy and pelvic muscle exercises on bladder health. Conclusion The PLUS BH‐KAB instrument may be used independently or in conjunction with other KAB instruments for a more comprehensive assessment of women's KAB related to bladder health. The BH‐KAB instrument can inform clinical conversations, health education programming, and research examining potential determinants of bladder health, LUTS, and related behavioral habits (e.g., toileting, fluid intake, pelvic muscle exercises).

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“…These behaviors have been shown to contribute to LUTS development over time. 4 One of the major contributing risk factors for LUTS development in nurses is delayed voiding. Voiding delays weaken the pelvic floor muscles, which help maintain continence.…”

Section: Stressors and Bathroom Behaviors Associated With Urinary Inc...mentioning

confidence: 99%

“…Voiding in advance of the biological urge to do so is considered premature voiding. When one is delaying voiding, they're ignoring the urges to void and instead “hold urine.” These behaviors have been shown to contribute to LUTS development over time 4…”

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confidence: 99%