Voiding dysfunction and access to toilets among elementary school children: A Toulouse school district study

Abstract

To determine the prevalence of such disorders in elementary schools (students from 1st to 5th grade) and analyze the role of access to school toilets on voiding habits. Observational, descriptive epidemiological study during the 2017-2018 school year by electronic questionnaire with parents of pupils attending elementary school. 2119 questionnaires were analyzed. The graders sex ratio was 1.07 (1087 boys). 410 families (19%) were classified as "popular" class. First, second and third graders represented 60% of the enrollment (N = 1273). Overall use of school toilets was 87% and 69% of students had appropriate use for urine. The main obstacles to their use were lack of hygiene and comfort (51%), lack of security or privacy (33%), limited accessibility (28%). The overall prevalence of urinary elimination disorders was 9%. Girls had more inappropriate use of the toilet for urine (36% vs 27%, OR 1.5, P = 0.0004). The factors associated with urinary elimination disorders were: not using the toilet (13% vs 9%, OR 1.5, P=0.04), being a girl (14% vs 5%, OR 3.5, P < 0.0001), belonging to the working class (14% vs 8% OR 1.8, P = 0.0008). This situation, which is a long-denounced major public health problem, mainly affects girls and also reveals social inequalities in the use of school toilets.