SUFU 2021: Toileting Behaviors in Adult Women with Recurrent Urinary Tract Infections in a Large Cross Sectional Survey Study

( The aim of this secondary analysis was to assess whether women with recurrent urinary tract infections (rUTIs) report more unhealthy bladder and bowel habits. The sample was 6,074 non-institutionalized, adult U.S. women recruited through online 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.

The primary comparison was between women who did (n=324, 5.3%) and did not report a history of rUTIs (i.e. >3 UTIs requiring treatment in the last year). Race was similar between the two groups, with average age 40.8 ± 15 years. 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 when busy, avoiding public toilets, and waiting to void until a strong urge and/or leakage. Additionally, women with rUTIs reported less commonly sitting to void when away from home, and more commonly crouching or hovering over the toilet or squatting on the seat both at home or away. Women with rUTIs more frequently reported constipation. The authors concluded that this cross-sectional study of adult women, those with a history of rUTIs reported a higher prevalence of unhealthy bladder habits, and perhaps modification of such behaviors may be a target for the management of these women.

Presented by: Elisabeth Sebesta, MD,1 Elizabeth Rourke, MD,1 Casey Kowalik, MD,2 Melissa Kaufman, MD,1 Roger Dmochowski, MD,1 W. Stuart Reynolds MD1

  1. Vanderbilt University Medical Center Department of Urology
  2. University of Kansas Medical Center Department of Urology

Written by: Diane K. Newman, DNP, CRNP, FAAN, BCB-PMD, Nurse Practioner and Co-Director, Penn Center for Continence and Pelvic Health Adjunct Professor of Urology in Surgery during the 2021 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Winter Meeting


  1. Kowalik, et al., Toileting Behaviors of Women-What is Healthy? J Urol, 2019. 201(1): p. 129-134.