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Bladder Health in Women

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (15 February 2020) | Viewed by 22372

Special Issue Editor


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Guest Editor
School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Interests: bladder health; women's health; aging; behavior and environment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

A Special Issue on women’s bladder health is timely given the prevalence of lower urinary tract symptoms (LUTS) in women. Prevalent LUTS include urinary incontinence and overactive bladder; the burden of these conditions at the individual and societal levels increase as women age. Despite their prevalence, many women do not seek help for LUTS. They are costly to manage, affect work productivity and participation, and quality of life, and they are associated with other co-morbidities, e.g., depression and obesity. Until recently, LUTS interventions at the individual level have been the main research focus, but a paradigm shift is occurring as multi- and trans-disciplinary research efforts are identifying multi-level socio-ecological factors that may act as risk or protective factors of bladder health, which may lead to LUTS prevention and bladder health promotion interventions.

Recent research has provided evidence that the environment plays a significant role in women’s behaviors related to emptying their bladders. Some women avoid public restrooms or are unable, due to external constraints, to urinate in a timely manner while at work or school. In this Special Issue the emphasis is on the role of physical and social environments, access to and adequacy and availability of toilet facilities, and the influence of culture, public and institutional policies, group norms, common beliefs, attitudes, and behaviors on the bladder health of women of all ages.

Prof. Dr. Mary H. Palmer
Guest Editor

Manuscript Submission Information

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Keywords

  • Lower urinary tract symptoms
  • Urinary incontinence
  • Overactive bladder
  • Social environment
  • Toilet facilities

Published Papers (5 papers)

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Research

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17 pages, 684 KiB  
Article
Why Do Women Not Use the Bathroom? Women’s Attitudes and Beliefs on Using Public Restrooms
by Siobhan M. Hartigan, Kemberlee Bonnet, Leah Chisholm, Casey Kowalik, Roger R. Dmochowski, David Schlundt and W. Stuart Reynolds
Int. J. Environ. Res. Public Health 2020, 17(6), 2053; https://doi.org/10.3390/ijerph17062053 - 20 Mar 2020
Cited by 16 | Viewed by 6859
Abstract
There are a variety of factors and influences, both internal and external, that may impact an individual’s public toileting experience and may ultimately have repercussions for bladder health. This study sought to identify predominant constructs underlying a women’s attitude towards using restrooms at [...] Read more.
There are a variety of factors and influences, both internal and external, that may impact an individual’s public toileting experience and may ultimately have repercussions for bladder health. This study sought to identify predominant constructs underlying a women’s attitude towards using restrooms at work, at school, and in public in order to develop a conceptual model incorporating these themes. We performed a secondary analysis of a cross-sectional, survey-based study that included open-ended questions about limitations to restroom use using a mixed-methods approach. Qualitative data coding and analysis was performed on 12,583 quotes and, using an iterative inductive-deductive approach, was used to construct the conceptual framework. Our conceptual framework reveals a complicated interplay of personal contexts, situational influences, and behavioral strategies used by women to manage their bladder and bowel habits away from home. These findings can inform future research and public policy related to bladder health awareness related to toilet access in the workplace and in public. Full article
(This article belongs to the Special Issue Bladder Health in Women)
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16 pages, 320 KiB  
Article
U.S. Adolescent and Adult Women’s Experiences Accessing and Using Toilets in Schools, Workplaces, and Public Spaces: A Multi-Site Focus Group Study to Inform Future Research in Bladder Health
by Deepa R. Camenga, Sonya S. Brady, Cecilia T. Hardacker, Beverly R. Williams, Jeni Hebert-Beirne, Aimee S. James, Kathryn Burgio, Jesse Nodora, Jean F. Wyman, Amanda Berry, Lisa K. Low and The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium
Int. J. Environ. Res. Public Health 2019, 16(18), 3338; https://doi.org/10.3390/ijerph16183338 - 10 Sep 2019
Cited by 25 | Viewed by 4347
Abstract
The World Health Organization recognizes access to clean and safe toilets as crucial for public health. This study explored U.S. adolescent and adult cisgender women’s lived experiences accessing toilets in schools, workplaces, and public spaces. As part of the Prevention of Lower Urinary [...] Read more.
The World Health Organization recognizes access to clean and safe toilets as crucial for public health. This study explored U.S. adolescent and adult cisgender women’s lived experiences accessing toilets in schools, workplaces, and public spaces. As part of the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium, we conducted 44 focus groups with female participants (n = 360; ages 11–93). Focus groups were stratified by age (11–14, 15–17, 18–25, 26–44, 45–64, 65+) and conducted across 7 geographically diverse U.S. sites from July 2017–April 2018. Using a transdisciplinary approach, we conducted conventional qualitative coding informed by our PLUS conceptual framework and used content analysis processes to identify salient themes. Across settings, toilet access was restricted by “gatekeepers” (i.e., individuals who control access to toilets). In contrast, self-restricting toilet use (deciding not to use the toilet despite biologic need to urinate) was based on internalized norms to prioritize school and job responsibilities over urination. In public spaces, self-restricting use was largely in response to lack of cleanliness. Across the life course, participants perceived gender disparities in the ability to easily access public toilets. Further research is needed to determine if and how these factors impact bladder health across the life course. Full article
(This article belongs to the Special Issue Bladder Health in Women)
18 pages, 662 KiB  
Article
Bladder Health Experiences, Perceptions and Knowledge of Sexual and Gender Minorities
by Cecilia T. Hardacker, Anna Baccellieri, Elizabeth R. Mueller, Linda Brubaker, Georgia Hutchins, Jory Luc Yimei Zhang and Jeni Hebert-Beirne
Int. J. Environ. Res. Public Health 2019, 16(17), 3170; https://doi.org/10.3390/ijerph16173170 - 30 Aug 2019
Cited by 18 | Viewed by 4082
Abstract
While recent efforts have been made to understand the bladder health experiences, perceptions, and knowledge of cisgender adolescent females and women, virtually nothing is known about the bladder health experiences of people who identify as sexual and gender minorities (SGMs). A community-based participatory [...] Read more.
While recent efforts have been made to understand the bladder health experiences, perceptions, and knowledge of cisgender adolescent females and women, virtually nothing is known about the bladder health experiences of people who identify as sexual and gender minorities (SGMs). A community-based participatory research approach using a focus group methodology to engage 36 adult participants who identify as SGM, including individuals who identify as gender non-conforming, queer, transgender (trans) men, or lesbian, in one of six focus group discussions on bladder health. Using directed content qualitative data analysis from the six unique focus groups, three interrelated themes were revealed: gender socialization of voiding behavior and toilet environment culture producing identity threats, and risks to gender affirmation; consequences of hetero-cis normative bathroom infrastructure necessitating adaptive voiding behaviors; and, physical and psychosocial consequences of chronic anxiety and fear are associated with voiding experiences. Insight on how SGMs navigate voiding behaviors, toilet experiences, and health care seeking is needed to assure that bladder health promotion activities are inclusive of this population’s needs. Full article
(This article belongs to the Special Issue Bladder Health in Women)
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Review

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17 pages, 851 KiB  
Review
Toileting Behaviors Related to Urination in Women: A Scoping Review
by Chen Wu, Kaikai Xue and Mary H. Palmer
Int. J. Environ. Res. Public Health 2019, 16(20), 4000; https://doi.org/10.3390/ijerph16204000 - 19 Oct 2019
Cited by 11 | Viewed by 4963
Abstract
This scoping review explores the state of science regarding women’s toileting behaviors, gaps in knowledge, and areas for future research. Online databases were searched to identify papers published in English between January 2010 through July 2019; the search identified 25 articles. The Toileting [...] Read more.
This scoping review explores the state of science regarding women’s toileting behaviors, gaps in knowledge, and areas for future research. Online databases were searched to identify papers published in English between January 2010 through July 2019; the search identified 25 articles. The Toileting Behaviors–Women’s Elimination Behaviors scale has been published in four validated language versions and used in 17 of the 25 studies. The most frequent behaviors include concern about public toilet cleanliness, delaying urination when busy or away from home, and using different toileting postures at and away from home. Determinants of toileting behaviors include environmental factors, chronic health conditions, and cognitive/psychological factors. Associations were found between toileting behaviors and lower urinary tract symptoms and between toileting postures and uroflowmetric parameters and post-void residual volume. Strategies that address modifiable determinants of toileting behaviors should be developed and tested in future research. Furthermore, little is known about the toileting behaviors and bladder health in older women and women from developing countries. Rigorous studies are needed to better understand the underlying mechanisms of toileting behaviors, the nature of associations between toileting behaviors and lower urinary tract symptoms, and effects of the environment on women’s toileting behaviors. Full article
(This article belongs to the Special Issue Bladder Health in Women)
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Other

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2 pages, 213 KiB  
Reply
Reply to Comment on Hardacker, C.T.; Baccellieri, A.; Mueller, E.R.; Brubaker, L.; Hutchins, G.; Zhang, J.L.Y.; Hebert-Beirne, J. Bladder Health Experiences, Perceptions and Knowledge of Sexual and Gender Minorities. Int. J. Environ. Res. Public Health 2019, 16, 3170
by Cecilia T. Hardacker, Anna Baccellieri, Elizabeth R. Mueller, Linda Brubaker, Georgia Hutchins, Jory Luc Yimei Zhang and Jeni Hebert-Beirne
Int. J. Environ. Res. Public Health 2020, 17(7), 2458; https://doi.org/10.3390/ijerph17072458 - 04 Apr 2020
Cited by 1 | Viewed by 1555
Abstract
We appreciate your comments and concerns about our manuscript in IJERPH on Bladder Health Experiences, Perceptions and Knowledge of Sexual and Gender Minorities [...] Full article
(This article belongs to the Special Issue Bladder Health in Women)
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