The effect of toilet and genital hygiene behaviors of women on lower urinary system symptoms

This master's thesis aimed to identify the effect of women's toileting and genital hygiene behaviors on lower urinary tract symptoms. The study was conducted in a cross-sectional manner with 300 married women in the 18-49 years age group who presented for the purpose of physical examination to a family health center of a district in Central Anatolia between 29.01.2024 and 26.03.2024. The data of the study was collected by using a questionnaire containing 32 questions, the "Bristol Female Lower Urinary Tract Symptoms (BFLUTS) Questionnaire", the "Toileting Behaviors - Women's Elimination Behavior Scale" and the "Genital Hygiene Behavior Inventory". Descriptive statistics were used for study data evaluation, and the t-test in independent groups and Welch ANOVA test were used, the Pearson correlation, simple and multiple linear regression analyzes were performed. While all participants experienced at least one lower urinary tract symptom, the incidence of symptoms related to storage, urination, urinary incontinence, sexual function, and the quality of life were 99.7%, 79.3%, 64.7%, 35.3%, and 66.7%, respectively. The percentage of women who presented to a physician for physical examination due to a condition that affects urination or due to urinary incontinence was 63.7%. A strong positive relationship was found between the total score of the Bristol Female Lower Urinary Tract Symptoms Questionnaire and the overall score of the Toileting Behaviors - Women's Elimination Behaviors Scale, while there was a strong negative relationship with the Genital Hygiene Behaviors Inventory. As a result of regression analysis, a one-point increase in the "preferred place for urination", "early urination", "delay in urination" and "difficulty in urination" sub-dimensions of the Toileting Behaviors - Women's Elimination Behaviors Scale was found to increase the total score of the Bristol Female Lower Urinary Tract Symptoms Questionnaire by 3.03, 2.50, 2.07, and 1.11 points respectively. In contrast, a one-point increase in the overall score of the Genital Hygiene Behaviors Inventory decreased the total score of the Bristol Female Lower Urinary Tract Symptoms Questionnaire by 0.84 points. In the presence of other variables that were found to have a statistically significant difference in pairwise comparisons with the dependent variable, a one-point increase in the total score of the Toileting Behaviors - Women's Elimination Behavior Scale increased the total score of the Bristol Female Lower Urinary Tract Symptoms Questionnaire by 1.17 points, while an increase in the total score of the Genital Hygiene Behaviors Inventory decreased it by 0.11 points. These results showed that lower urinary tract symptoms are common in women and treatment-seeking behavior is therefore inadequate, and that toileting and genital behaviors are factors in the development of this health problem. In this regard, it is necessary to increase the awareness of women and the health care professionals who provide health services to them regarding lower urinary tract symptoms in order to diagnose and treat the health problem, and to provide training and the necessary information to preserve a healthy bladder and support correct genital hygiene habits. Key Words: Lower urinary tract symptoms, toileting behaviors, genital hygiene behaviors, prevalence, treatment-seeking behavior, nursing