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Toileting Behaviors and Recurrent Urinary Tract Infections in Premenopausal Women: A Case-Control Study
Dalia Malaeb1, Lina El Taha1,2, Fadi Constantinos3
1Department of Obstetrics and Gynecology, American University of Beirut Medical Center, PO Box: 11-0236, Beirut, 1107 2020, Riad El Solh, Lebanon.
International Urogynecology Journal
|March 23, 2026
Summary
Dysfunctional toileting behaviors (TB) like straining and voiding preferences are linked to recurrent urinary tract infections (RUTI) in premenopausal women. Modifying these habits may help reduce RUTI incidence.
Area of Science:
- Urology
- Behavioral Science
Background:
- Recurrent urinary tract infections (RUTI) significantly impact premenopausal women's quality of life.
- The role of toileting behaviors (TB) in the development of RUTI is not fully understood.
Purpose of the Study:
- To investigate the association between dysfunctional toileting behaviors (TB) and recurrent urinary tract infections (RUTI) in premenopausal women.
- To utilize a validated behavioral assessment scale to quantify TB.
Main Methods:
- A case-control study involving 294 premenopausal women (98 with RUTI, 196 controls).
- Data collected via structured questionnaire including the Toileting Behaviors-Women's Elimination Behavior (TB-WEB) scale.
- Statistical analyses included t-tests, chi-square, and logistic regression.
Main Results:
- Women with RUTI exhibited higher scores in dysfunctional TB domains: place preference, premature voiding, delayed voiding, and straining.
- A preference for crouching over sitting was more common in women with RUTI.
- Habitual dysfunctional TB predated RUTI diagnosis in over 62.5% of cases.
Conclusions:
- A significant association exists between dysfunctional toileting behaviors and RUTI in premenopausal women.
- Further research is needed to elucidate causal links and develop targeted interventions.
- Modifying toileting behaviors may be a strategy to reduce RUTI incidence.
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