What mechanisms link toilet insecurity and urinary symptoms?

In this video, Elisabeth M. Sebesta, MD, discusses potential mechanisms linking insecurity and both urinary symptoms and psychosocial factors. She is an author of the Urology study “Household Toilet and Sanitation Insecurity is Associated with Urinary Symptoms, Psychosocial Burden, and Compensatory Bladder Behaviors.” Sebesta is an assistant professor of urology at Vanderbilt University Medical Center in Nashville, Tennessee.

Transcription:

Your results highlight the association between insecurity and both urinary symptoms and psychosocial burden. Can you elaborate on the potential mechanisms linking these factors?

We talked a little bit about how I think that urinary symptoms might play into this. But basically as kind of mechanisms to understand the associations that I observed between being at risk for toilet and sanitation insecurity and worse urinary symptoms, we looked at both psychosocial burden and then some coping behaviors. And so in terms of the psychosocial aspect of things, people with toilet insecurity are more likely to experience greater stress and anxiety, report poorer social support, have a poor overall perception of their health, again, even after controlling for some confounders. And so this, I think, becomes like a moderator to link these 2 associations. We know that psychosocial burden can be experienced by people with worse urinary symptoms. This has been observed in many urologic conditions: overactive bladder, incontinence. And so if you have a lot of urinary frequency and you don't have good, reliable access to a toilet, it makes sense that this would like increase your overall stress and anxiety around this situation. And so my hypothesis is that the psychosocial burden experienced by people affected by this then becomes part of the mechanism that helps to drive the cycle forward and perpetuate it.

This transcription was edited for clarity.