Men with benign prostate hypertrophy, a condition in which the prostate
is enlarged, are shown to urinate better in sitting position compared to
standing. According to a new study published in PLOS ONE, this
position is related to a reduced amount of urine in the bladder after
Prone to complications
For most men, the
prostate grows with age. Due to this enlargement, the urinary flow decreases
and urine may be left in the bladder after urinating. Men with an enlarged
prostate are prone to complications, such as cystitis and bladder stones.
Read: Symptoms of enlarged prostate
doctors advise these patients to urinate in the sitting position. However,
until today there was no clinical evidence for this advice,” according to Ype de
Jong, fifth year medical student at the LUMC and joint first author of the
shared first authors Ype de Jong, Hans Pinckaers and Robin ten Brinck studied
scientific articles on the subject of urination and position. Led by the
urologist Prof. Dr. Lycklama à Nijeholt and epidemiologist Dr. Dekkers, they
selected 11 articles that were eligible for statistical analysis.
were surprising: men with urologic problems related to an enlarged prostate
were shown to urinate better in the sitting position. The amount of urine that
remains in the bladder is reduced, while a trend towards an increased urinary
flow and shorter time spent urinating is seen.
Read: Urinary hesitancy
The explanation is simple: “In
the sitting position, the muscles of the pelvic floor and legs are more relaxed
which allows for a less obstructed voiding of urine”, says De Jong.
Difficulty emptying the bladder completely
Problems related to
an enlarged prostate can occur in middle-aged man and are age related. However,
the elderly suffer the most. “Of men above 80 years old, more than 90 percent
have difficulties urinating due to an enlarged prostate.
"Due to their age,
these men are prone to fall if they urinate in the standing position. In
reflex, the anxiety to fall results in contraction of the pelvic muscles,
making it difficult to empty the bladder completely.”
Read: Something for your prostate?
Drugs that cause
the muscles surrounding the bladder to relax can provide relief of symptoms.
However, De Jong and co-authors now show that sitting during urination is
almost as effective. “However, we do not advise patients to stop taking their
prescribed medication. Combining this medication with urinating in the sitting
position may give the best clinical results,” according to De Jong.
important result of the study is the effect of position on healthy males – or
more correctly, the absence of effect. Hans Pinckaers: "No influence of
position was found in healthy males."
"This means that for this group, there are
no medical arguments to change voiding position.” Robin ten Brinck adds: “We understood that the subject of our study sometimes leads to
discussions, especially between couples. For the first time it is possible to
provide, not only hygienic, but also solid scientific arguments.”
How would you know if something was wrong with your prostate?
Saw palmetto (Serenoa repens [Bartram] Small)
Treatment of enlarged prostate
Image: Man sitting on toilet from Shutterstock
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