MP02-09 TOILETING BEHAVIORS IN ADULT WOMEN WITH RECURRENT URINARY TRACT INFECTIONS IN A LARGE POPULATION SURVEY STUDY

Abstract

INTRODUCTION AND OBJECTIVE: Urinary tract infections (UTIs) are extremely prevalent in the female population. In female children, recurrent UTIs (rUTIs) have been linked to toileting habits including infrequent voiding, poor fluid intake, stool retention, and toilet hygiene, and often management targets such behaviors. However, the same association has not been made in adult women. In this study, we aimed to assess whether women with rUTIs report more unhealthy bladder and bowel habits. METHODS: This is a secondary analysis of a sample of 6,074 non-institutionalized, adult U.S. women recruited through online advertisement with ResearchMatch. Women completed validated questionnaires assessing demographic and clinical history, toileting behaviors (TB-WEB), urinary symptoms (ICIQ-FLUTS), and bowel habits (ICIQ-BS). Subjects were excluded if they were pregnant, used a urinary catheter, or had a history of cystectomy, neurogenic bladder, or neurological disorder. Our primary comparison was between women who did and did not report a history of rUTIs (i.e. three of more UTIs requiring treatment in the last year). All statistics were performed in STATA, with p <0.05 considered significant. RESULTS: Of our sample, 324 (5.3%) reported a history of rUTIs. Age and race were similar between the two groups, with average age 40.8 ± 15 years. Comorbid conditions including diabetes, heart disease, hypertension, irritable bowel syndrome, anxiety, and depression were more common in women with rUTIs. Women with rUTIs more commonly reported holding urine when away from home or busy, avoiding public toilets, and waiting to void until a strong urge and/or leakage. Additionally, women with rUTIs reported sitting to void less often when away from home, and more commonly crouch or hover over the toilet or squat on the seat both at home or away, although these differences were not significant. Finally, women with rUTIs more frequently reported constipation. CONCLUSIONS: In this cross-sectional study, adult women rUTIs reported a higher prevalence of unhealthy bladder habits including limiting bathroom use and holding urine, constipation, and comorbid conditions. In the future it is worth considering whether modification such behaviors may be a target for management of these women.