Characterizing voiding experiences of men choosing seated and standing positions

Abstract

Voiding positions and preferences in men are not well characterized. In this study, we aim to understand the interplay of voiding characteristics and their impact on voiding position. Methods: We designed a 27-item survey to assess voiding characteristics and lower urinary tract symptoms (LUTS) severity in men seen in urology and other outpatient clinics. Participants included adult men patients and adult men accompanying patients at our institution's outpatient clinics. Data collected included demographics, International Prostate Symptom Score questionnaire, stream type (single, split, and dribble), voiding behavior, positional stream quality, and voiding bother. Results: We received 195 completed surveys (80% response rate). Of men queried, 18% (35/195) preferred to sit while voiding. Overall, men who sit had a higher proportion of LUTS (66% [23/35] vs. 41% [66/160]; p = .01), more physical limitations affecting voiding choice (20% [7/35] vs. 3% [5/160]; (p = .001), and a lower desire to stand (6% [2/35] vs. 24% [38/160]; p = .02), compared to men who stand. Men who sit while voiding reported nearly double the amount of voiding associated bother (34% [12/35]) compared to men who stand (18% [28/160]; p = .04). Older aged men reported a similar rate of seated urination compared to younger men. The most common reasons to void seated included comfort and avoidance of spraying. Conclusions: Our findings discourage the use of anecdotal beliefs founded on generalizable characteristics, such as age and stream type, to infer a patient's voiding characteristics. Open dialog with patients regarding voiding preferences may garner important information regarding overall urologic health and better inform urologic care.

Through the zipper or pants down: Does it change uroflowmetry parameters in healthy males?

“…Consequently, they revelaed that the preferred voiding position was largely associated with physical limitations. However, the participants did not state differences for stream quality between both position 11 . Last but not least, researchers from Japan compared a series of voiding positions in normal males; they indicated that Qmax was highest in the prone position, followed by standing, sitting, supine, and the lateral positions 5 …”

“…Similarly, another study stated that uroflowmetry should always be performed in the preferred position 7 . Thus, the most comfortable position should be chosen for voiding in uroflowmetry 1,8,11,17 . Hence, we only included participants whose natural voiding position was standing and excluded the effect of other voiding positions.…”

“…In addition, the seated position is opted more often for men of older age. Besides, some patients have to choose the recumbent or sitting position for medical reasons 10,11 . Data on the extent to which urination varies by position are insufficient.…”

“…[7][8][9][10] The preferred voiding position is influenced by a variety of factors such as medical conditions, cultural conventions, and comfort. 3,11 While most men prefer to void in standing position, it is customary in various societies for many men to void in squatting position. In addition, the seated position is opted more often for men of older age.…”

“…Besides, some patients have to choose the recumbent or sitting position for medical reasons. 10,11 Data on the extent to which urination varies by position are insufficient. Various studies have found that flow rates are better in a sitting position, 7,12 whereas other studies have shown that a standing or squatting position provides an optimal flow rate.…”