Association between toileting behaviors and overactive bladder symptoms among female university students in Lebanon and Armenia: a comparative study

Abstract Background: Overactive bladder (OAB) is a prevalent lower urinary tract symptom syndrome among young women, with potentially modifiable behavioral risk factors including toileting behaviors. This cross-sectional study investigated the association between toileting behaviors and OAB symptoms among female university students in Lebanon and Armenia. Methods: A total of 812 female university students (402 from Lebanon and 410 from Armenia) completed an online survey including the Toileting Behaviors–Women's Elimination Behaviors Scale (TB-WEB) and the 8-item Overactive Bladder Questionnaire (OAB-V8). Spearman correlation, chi-square tests, Mann–Whitney U tests, and descriptive statistics were used to analyze the data. Statistical significance was set at p < 0.05. Results: OAB symptoms were present in 52.5% of Lebanese and 39.0% of Armenian participants. Lebanese students had higher TB-WEB scores (49.26 ± 8.77 vs. 44.82 ± 6.50) and OAB scores (8.01 ± 4.16 vs. 7.02 ± 5.48) (both p < 0.001). Total TB-WEB scores were positively correlated with OAB scores in both Lebanon (ρ = 0.680, p < 0.001) and Armenia (ρ = 0.312, p < 0.001). Delayed voiding showed the strongest association with OAB in Lebanon (ρ = 0.687, p < 0.001), whereas premature voiding was significantly associated with OAB only in Armenia (ρ = 0.264, p < 0.001). Conclusion: Unhealthy toileting behaviors were significantly associated with OAB symptoms in both countries, with notable differences in behavioral patterns. These findings highlight the importance of addressing toileting behaviors as potentially modifiable factors in bladder health interventions for young women.