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. 2020 Aug;204(2):310-315.
doi: 10.1097/JU.0000000000000812. Epub 2020 Feb 25.

Women's Perceptions of Public Restrooms and the Relationships with Toileting Behaviors and Bladder Symptoms: A Cross-Sectional Study

W Stuart Reynolds  1 , Casey Kowalik  2 , Melissa R Kaufman  1 , Roger R Dmochowski  1 , Jay H Fowke  3
Affiliations

Women's Perceptions of Public Restrooms and the Relationships with Toileting Behaviors and Bladder Symptoms: A Cross-Sectional Study

W Stuart Reynolds et al. J Urol. 2020 Aug.

Abstract

Purpose: Because current knowledge about public restroom use and bladder health is limited, we sought to identify why women avoid public restrooms and the associations of lower urinary tract symptoms and toileting behaviors.

Materials and methods: Between October and December 2017 we recruited a convenience sample of U.S. women to complete a cross-sectional, anonymous questionnaire about public restroom use, lower urinary tract symptoms (International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms [ICIQ-FLUTS]) and toileting behavior (Web-Based Toileting Behavior [TB-WEB]). We compared women who reported limiting public restroom use all or most of the time to those who did not limit or did so occasionally or sometimes.

Results: Of the 6,004 women in the study 26% limited public restroom use most or all of the time and were more concerned with cleanliness than those who did not limit public restroom use. They also reported more often using nonsitting positions when away from home and holding urine to avoid public restrooms, higher ICIQ-FLUTS scores, more frequent overactive bladder and fewer than 7 voids a day.

Conclusions: A large number of women reported avoiding public restrooms, often over concerns of cleanliness, availability of amenities and privacy. Women who habitually limit public restroom use more frequently reported unhealthy toilet behaviors and lower urinary tract conditions. These findings will help guide future research and inform public policy and bladder health awareness.

Keywords: lower urinary tract symptoms; public health; toilet facilities; urinary incontinence; women.

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Figures

Figure 1.
Figure 1.
Participant disposition and creation of analytic data set
Figure 2.
Figure 2.
Proportion of women who avoid public restrooms and reasons why.
Figure 3.
Figure 3.
Mean visual analog scale scores for public restroom attributes, according to whether or not they avoid public restrooms.
See this image and copyright information in PMC

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