School Toileting Environment, Bullying, and Lower Urinary Tract Symptoms in a Population of Adolescent and Young Adult Girls: Preventing Lower Urinary Tract Symptoms Consortium Analysis of Avon Longitudinal Study of Parents and Children

David A Shoham, Zhenxun Wang, Sarah Lindberg, Haitao Chu, Linda Brubaker, Sonya S Brady, Tamera Coyne-Beasley, Colleen M Fitzgerald, Sheila Gahagan, Bernard L Harlow, Carol Joinson, Lisa Kane Low, Alayne D Markland, Diane K Newman, Ariana L Smith, Ann Stapleton, Siobhan Sutcliffe, Amanda Berry

Research output: Contribution to journalArticle (Academic Journal)

Abstract

OBJECTIVES: To examine whether the school toilet environment at age 13, including bullying at toilets, is associated with female lower urinary tract symptoms (LUTS) at ages 13 and 19, as little is known about the association among school toilet environment, voiding behaviors, and LUTS in adolescent girls.

METHODS: The sample comprised 3962 female participants from the Avon Longitudinal Study of Parents and Children. At age 13, participants reported on 7 school toilet environment characteristics and a range of LUTS items. At age 19, participants completed the Bristol Female Lower Urinary Tract Symptoms questionnaire.

RESULTS: All toilet environmental factors were associated with at least 1 LUTS outcome at age 13. Holding behavior was associated with all school toilet environmental factors, with odds ratios ranging from 1.36 (95% confidence interval [CI]: 1.05, 1.76) for dirty toilets to 2.38 (95% CI: 1.60, 3.52) for feeling bullied at toilets. Bullying was associated with all daytime LUTS symptoms and nocturia; odds ratios ranged from 1.60 (95% CI: 1.04, 2.07) for nocturia to 2.90 (95% CI: 1.77, 4.75) for urgency. Associations between age 13 school toilets and age 19 LUTS were in the same direction as age 13 LUTS.

CONCLUSION: This is the first examination of associations between school toilets and LUTS. Toileting environments were cross-sectionally associated with LUTS in adolescent girls. While further work is needed to determine whether these associations are causal, school toilet environments are modifiable and thus a promising target for LUTS prevention.

Original languageEnglish
JournalUrology
Early online date14 Jul 2020
DOIs
Publication statusE-pub ahead of print - 14 Jul 2020

Bibliographical note

Copyright © 2020. Published by Elsevier Inc.

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    Shoham, D. A., Wang, Z., Lindberg, S., Chu, H., Brubaker, L., Brady, S. S., Coyne-Beasley, T., Fitzgerald, C. M., Gahagan, S., Harlow, B. L., Joinson, C., Low, L. K., Markland, A. D., Newman, D. K., Smith, A. L., Stapleton, A., Sutcliffe, S., & Berry, A. (2020). School Toileting Environment, Bullying, and Lower Urinary Tract Symptoms in a Population of Adolescent and Young Adult Girls: Preventing Lower Urinary Tract Symptoms Consortium Analysis of Avon Longitudinal Study of Parents and Children. Urology. https://doi.org/10.1016/j.urology.2020.06.060