Toileting Behaviours and Their Association with Lower Urinary Tract Symptoms in Women: A Scoping Review

Abstract

Lower urinary tract symptoms (LUTS) are common among women and have been associated with demographic, behavioural, environmental, and occupational factors. Toileting behaviours (TB) have emerged as potentially modifiable contributors to bladder health; however, the scope and characteristics of the existing evidence remain unclear. We conducted a scoping review to synthesize evidence on toileting behaviours and their associations with LUTS among women. The review followed Joanna Briggs Institute methodology and was reported in accordance with PRISMA-ScR guidelines. Comprehensive systematic literature search across four databases, including PubMed, Scopus, ScienceDirect, and Google Scholar to ensure inclusion of diverse studies published between 2006 and 2025 was conducted. Eligible studies included qualitative, quantitative, and mixed-methods research examining toileting behaviours in relation to LUTS among women aged >=18 years. Data were extracted using a structured charting form and synthesized narratively, with methodological quality appraised descriptively using JBI tools. Thirty-two studies were identified, predominantly cross-sectional in design. Reported LUTS prevalence ranged from 9.9% to 97.1%, reflecting heterogeneity in populations and measurement approaches. Unhealthy toileting behaviours including delayed voiding, convenience voiding, straining, and toilet avoidance were associated with greater symptom burden. Occupational and environmental constraints, particularly restricted toilet access and poor sanitation, were frequently described as influencing factors. Overall, the findings suggest consistent associations between toileting behaviours and LUTS; however, longitudinal and interventional studies are needed to clarify causal pathways and inform prevention strategies