Comparison of overactive bladder symptoms and toileting behaviors between imams and male teachers: a cross-sectional study

BACKGROUND: Toileting behaviors and occupational constraints are increasingly recognized as contributors to lower urinary tract symptoms (LUTS) and overactive bladder (OAB). Religious practices involving ritual ablution require pre-emptive voiding multiple times daily, yet no study has examined whether such behaviors influence OAB symptoms. This study compared urinary habits, occupational stress, and OAB severity between imams, among whom ritual pre-ablution voiding was commonly reported, and male teachers, whose work may restrict timely restroom access. METHODS: In this cross-sectional study, 75 imams and 83 male teachers from Karasu, Türkiye completed validated questionnaires: the OAB-V8 for bladder symptoms, the Short Index of Job Satisfaction (SIJS), and the Turkish version of the General Work Stress Scale. Exclusion criteria included diabetes mellitus, previous lower urinary tract or prostate-related urological surgery, and medical treatment for benign prostatic hyperplasia. Group comparisons were performed using appropriate non-parametric tests. RESULTS: Teachers demonstrated significantly higher OAB-V8 scores than imams (median 8 vs. 6, p = 0.022). Imams reported more frequent pre-emptive voiding before ablution and predominantly seated voiding, whereas teachers reported toileting patterns shaped by work schedule and break structure. Stress scores were significantly higher among teachers, aligning with prior evidence linking occupational strain to OAB symptoms. Fluid and caffeine intake did not differ meaningfully between groups. Post-void dribbling was less common among imams (16.0% vs. 31.3%, p = 0.024). CONCLUSION: Ritually motivated pre-emptive voiding among imams may be associated with a lower OAB symptom burden. Conversely, restricted toileting opportunities and higher occupational stress may contribute to increased symptom burden among teachers. Prospective studies are needed to clarify causal pathways and evaluate ritual-based voiding as a behavioral correlate of OAB symptom patterns.