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Review
. 2014 Jul 22;9(7):e101320.
doi: 10.1371/journal.pone.0101320. eCollection 2014.

Urinating Standing Versus Sitting: Position Is of Influence in Men With Prostate Enlargement. A Systematic Review and Meta-Analysis

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Free PMC article
Review

Urinating Standing Versus Sitting: Position Is of Influence in Men With Prostate Enlargement. A Systematic Review and Meta-Analysis

Ype de Jong et al. PLoS One. .
Free PMC article

Abstract

Background: It is suggested that the body posture during urination can influence urodynamic parameters in patients with Lower Urinary Tract Symptoms (LUTS) to an extent approaching pharmacological interventions. In this article, the influence of body position during micturition on maximum urinary flow rate (Qmax), voiding time (TQ) and post-void residual volume (PVR) in healthy males and patients with LUTS is analyzed by means of a systematic review and meta-analysis.

Evidence acquisition: A systematic search was conducted in 14 medical databases. Studies comparing urodynamic parameters in standing versus sitting position were eligible for inclusion. Studies were stratified according to health status of included male participants: healthy individuals and patients with LUTS. Standardized mean differences for Qmax, TQ and PVR were pooled in a random effects model.

Results: Eleven articles were included. In men with LUTS, a significantly lower PVR (-24.96 ml; 95%CI -48.70 to -1.23) was shown in sitting position compared to standing. In accordance, Qmax was increased (1.23 ml/s; 95%CI -1.02 to 3.48), and TQ was decreased (-0.62 s; 95%CI -1.66 to 0.42) in sitting position, although these differences did not reach statistical significance. In healthy men, Qmax (0.18 ml/s; 95% CI -1.67 to 2.02), TQ (0.49 s; 95%CI -3.30 to 4.27) and PVR (0.43 ml; 95%CI -0.79 to 1,65) were similar in sitting and standing position.

Conclusion: For healthy men, no difference is found in any of the urodynamic parameters. In patients with LUTS, the sitting position is linked with an improved urodynamic profile.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA flowchart showing the study selection process.
Figure 2
Figure 2. Forest plot from random effects meta-analysis on the difference in maximum urinary flow rate (Qmax) in both healthy males and male patients with Lower Urinary Tract Symptoms (LUTS) in the sitting versus standing position.
Figure 3
Figure 3. Forest plot from random effects meta-analysis on the difference in voiding time (TQ) in both healthy males and male patients with Lower Urinary Tract Symptoms (LUTS) in the sitting versus standing position.
Figure 4
Figure 4. Forest plot from random effects meta-analysis on the difference in post-void residual volume (PVR) in both healthy males and male patients with Lower Urinary Tract Symptoms (LUTS) in the sitting versus standing position.

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Grant support

Expenses for the retrieval of included articles were being paid for by the department of Urology of the Leiden University Medical Center (LUMC). No other forms of funding or financial compensation was provided to the authors. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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