Pediatric urinary health and school health conditions in France: A political urgency?

Purpose: The high frequency of urinary disorders and their complications among school-aged children is common but few studies have investigated their predictors such as poor urinary hygiene habits, inappropriate use of school toilets, and deteriorated school toilets conditions. The question is whether individual factors (behaviors) conditioned by environmental factors (toilet conditions) play a role in functional urinary disorders.

Materials and methods: We performed an electronic cross-sectional observational study from October 1, 2023, to March 31, 2024, in the department of Vienne (France), among children's parents. The survey tool consisted in 43 questions and collected data on in the field of urinary habits at school and children's urinary health: 19 predictors for occurrence of urinary disorders were identified by univariate logistic regression.

Results: Of the 405 parents who completed the survey, 10 % indicated that their children had a urinary disorder. Inappropriate uses of toilets were found in 48 % of elementary school children and 18 % of preschoolers. Barriers to use toilets was predictor of urinary disorders (p < 0.005). Factors included the absence of door locking systems (p < 0.005), toilets not adapted to children's height (p < 0.05), insufficient toilet paper (p < 0.01), or lack of heating in the toilet block (p < 0.005).

Conclusion: This study confirms the significant and major impact of school sanitary conditions on urinary disorders in preschool and elementary school-aged children, mediated by inappropriate use of toilets, highlighting the necessity for health promotion interventions.