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Toileting behaviors and factors associated with urinary incontinence in college-aged female students in China

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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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References

  1. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21(1):5–26.

    Article  Google Scholar 

  2. Parden AM, Griffin RL, Hoover K, Ellington DR, Gleason JL, Burgio KL, et al. Prevalence, awareness, and understanding of pelvic floor disorders in adolescent and young women. Female Pelvic Med Reconstr Surg. 2016;22(5):346–54.

    Article  Google Scholar 

  3. Angelini KJ, Newman DK, Palmer MH. Psychometric evaluation of the toileting behaviors: women's elimination behaviors scale in a sample of college women. Female Pelvic Med Reconstr Surg. 2019. https://doi.org/10.1097/SPV.0000000000000711.

  4. Aoki Y, Brown HW, Brubaker L, Cornu JN, Daly JO, Cartwright R. Urinary incontinence in women. Nat Rev Dis Primers. 2017;3:17042.

    Article  Google Scholar 

  5. Harlow BL, Bavendam TG, Palmer MH, Brubaker L, Burgio KL, Lukacz ES, et al. The prevention of lower urinary tract symptoms (PLUS) research consortium: a transdisciplinary approach toward promoting bladder health and preventing lower urinary tract symptoms in women across the life course. J Women's Health (Larchmt). 2018;27(3):283–9.

    Article  Google Scholar 

  6. Wan X, Wu C, Xu D, Huang L, Wang K. Toileting behaviours and lower urinary tract symptoms among female nurses: a cross-sectional questionnaire survey. Int J Nurs Stud. 2016;65:1–7.

    Article  Google Scholar 

  7. Palmer MH, Willis-Gray MG, Zhou F, Newman DK, Wu JM. Self-reported toileting behaviors in employed women: are they associated with lower urinary tract symptoms? Neurourol Urodyn. 2018;37(2):735–43.

    Article  Google Scholar 

  8. Wang K, Palmer MH. Women's toileting behaviour related to urinary elimination: concept analysis. J Adv Nurs. 2010;66(8):1874–84.

    Article  Google Scholar 

  9. The State Council of Office of Population Censuses and Surveys. Data of the 2010 Census in China. China Statistics Press. 2012. http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm.

  10. Chinese Medical Association. Guidelines for diagnosis and treatment of chronic constipation in China. Chin J Dig. 2013;33(5):291–7.

    Google Scholar 

  11. Chinese Medical Association. Guidelines for clinical diagnosis and treatment of dysfunctional uterine bleeding. Chin J Obstet Gynecol. 2009;44(3):234–6.

    Google Scholar 

  12. Liu y WC, Sun T, Guan XM, Wang KF. Reliability and validity of the Chinese version of Women's toileting behavior scale: testing in community urinary incontinence. J Nurs Sci. 2012;27(16):78–80.

    Google Scholar 

  13. Huang L, Zhang SW, Wu SL, Ma L, Deng XH. The Chinese version of ICIQ: a useful tool in clinical practice and research on urinary incontinence. Neurourol Urodyn. 2008;27(6):522–4.

    Article  Google Scholar 

  14. Alves JO, Luz STD, Brandao S, Da Luz CM, Jorge RN, Da Roza T. Urinary incontinence in physically active young women: prevalence and related factors. Int J Sports Med. 2017;38(12):937–41.

    Article  Google Scholar 

  15. Zhang L, Zhu L, Xu T, Lang J, Li Z, Gong J, et al. A population-based survey of the prevalence, potential risk factors, and symptom-specific bother of lower urinary tract symptoms in adult Chinese women. Eur Urol. 2015;68(1):97–112.

    Article  Google Scholar 

  16. Xu D, Chen L, Wan X, Zhang Y, Liu N, Wang K. Toileting behaviour and related health beliefs among Chinese female nurses. Int J Clin Pract. 2016;70(5):416–23.

    Article  CAS  Google Scholar 

  17. Wan XJ, Zhang Y, Liu Y, Wu C, Wang KF. Reliability and validity of the Chinese version of women’ s toileting behavior scale among female nurses. Chin J Nurs. 2014;49(7):782–5.

    Google Scholar 

  18. Da Roza T, Brandao S, Mascarenhas T, Jorge RN, Duarte JA. Urinary incontinence and levels of regular physical exercise in young women. Int J Sports Med. 2015;36(9):776–80.

    Article  Google Scholar 

  19. van Breda HM, Bosch JL, de Kort LM. Hidden prevalence of lower urinary tract symptoms in healthy nulligravid young women. Int Urogynecol J. 2015;26(11):1637–43.

    Article  Google Scholar 

  20. O'Halloran T, Bell RJ, Robinson PJ, Davis SR. Urinary incontinence in young nulligravid women: a cross-sectional analysis. Ann Intern Med. 2012;157(2):87–93.

    Article  Google Scholar 

  21. Bedretdinova D, Fritel X, Panjo H, Ringa V. Prevalence of female urinary incontinence in the general population according to different definitions and study designs. Eur Urol. 2016;69(2):256–64.

    Article  Google Scholar 

  22. Bardino M, Di Martino M, Ricci E, Parazzini F. Frequency and determinants of urinary incontinence in adolescent and young nulliparous women. J Pediatr Adolesc Gynecol. 2015;28(6):462–70.

    Article  Google Scholar 

  23. Wu C, Wang K, Sun T, Xu D, Palmer MH. Predicting help-seeking intention of women with urinary incontinence in Jinan, China: a theory of planned behaviour model. J Clin Nurs. 2015;24(3–4):457–64.

    Article  Google Scholar 

  24. Ninomiya S, Naito K, Nakanishi K, Okayama H. Prevalence and risk factors of urinary incontinence and overactive bladder in Japanese women. Low Urin Tract Symptoms. 2018;10(3):308–14.

    Article  Google Scholar 

  25. Palmer MH, Newman DK. Women's toileting behaviours: an online survey of female advanced practice providers. Int J Clin Pract. 2015;69(4):429–35.

    Article  CAS  Google Scholar 

  26. Kowalik CG, Daily A, Delpe S, Kaufman MR, Fowke J, Dmochowski RR, et al. Toileting behaviors of women—what is healthy? J Urol. 2019;201(1):129–34.

    Article  Google Scholar 

  27. Xu D, Huang L, Gao J, Li J, Wang X, Wang K. Effects of an education program on toileting behaviors and bladder symptoms in overactive bladder patients with type 2 diabetes: a randomized clinical trial. Int J Nurs Stud. 2018;87:131–9.

    Article  Google Scholar 

  28. Lacima G, Espuna M, Pera M, Puig-Clota M, Quinto L, Garcia-Valdecasas JC. Clinical, urodynamic, and manometric findings in women with combined fecal and urinary incontinence. Neurourol Urodyn. 2002;21(5):464–9.

    Article  Google Scholar 

  29. Sjogren J, Malmberg L, Stenzelius K. Toileting behavior and urinary tract symptoms among younger women. Int Urogynecol J. 2017;28(11):1677–84.

    Article  Google Scholar 

  30. Gupta NP, Kumar A, Kumar R. Does position affect uroflowmetry parameters in women? Urol Int. 2008;80(1):37–40.

    Article  Google Scholar 

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Funding

The Qing Lan Project (no. 53041608) provided funding for this research to Dr. Zhou. The First Quality Bladder Health Initiative also provided funding for this study. The funding entities had no role in the study or publication of the findings.

Author information

Authors and Affiliations

  1. School of Nursing, Xuzhou Medical University, 209 Tongshan Road, Xuzhou, Jiangsu, China

    Fang Zhou & Kaikai Xue

  2. Department of Nursing, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China

    Yuping Liu

  3. School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China

    Lang Zhuo

  4. Anesthesiology, Beijing Tsinghua Changgung Hospital, Beijing, China

    Shumin Tu

  5. School of Nursing, The University of North Carolina at Chapel Hill, CB 7460, Chapel Hill, NC, 27599, USA

    Mary H. Palmer

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  1. Fang Zhou
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  2. Kaikai Xue
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Correspondence to Fang Zhou or Mary H. Palmer.

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First co-authors: Fang Zhou, Kaikai Xue, and Yuping Liu

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Zhou, F., Xue, K., Liu, Y. et al. Toileting behaviors and factors associated with urinary incontinence in college-aged female students in China. Int Urogynecol J 31, 961–971 (2020). https://doi.org/10.1007/s00192-019-04043-3

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  • DOI: https://doi.org/10.1007/s00192-019-04043-3

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