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Should men be sitting down to pee?

urinal

17 September 2020

Urinating while standing or sitting, which is better? This is a frequently asked question about the ideal urinary position during consultation hours for men with urinary complaints, which are usually caused by an enlargement of the prostate. Although this may seem like a simple question, there is quite a bit to say about it.

Is there a natural pee position for men?

To begin with, it is not entirely clear what a natural pee position is. In North-West Europe most of the men urinate standing, but in the (Middle) East it is customary to urinate while squatting. Possibly this is because Islam sets clear rules about posture when urinating.

Urination and hygiene

However, what is clear is that urinating while standing is less hygienic than urinating while sitting down. The pee jet travels a longer distance before it hits the toilet bowl or the ground, causing more splashing. This increases the chance that the clothing will be soiled by urine.

The hygienic aspect is also important in our society. In public toilets and school toilets, the toilets are often dirty, causing women, in particular, to hang over the toilet to urinate, which has been proven to be a wrong posture. Especially in nursery and primary schools, the dirty toilets are a cause of incorrect urination, which causes incontinence complaints to occur.

Research on urinary postures

By means of a urodynamic examination, the functioning of the bladder can be measured at different urinary positions. A urodynamic examination measures the strength of the urine stream (the flow), the amount of urine passed, the amount of urine that remains in the bladder after urination (residue after urination) and the pressure in the bladder during urination. The pressure in the bladder says something about the strength of the bladder muscle)

Research (pdf) into the Influence of voiding posture on urodynamic parameters in men (pdf) concluded that no difference could be indicated between bladder function in a sitting or standing posture. These were healthy men without urinary complaints.

According to research from the Leiden University Medical Centre in the Netherlands, sitting down to pee allows for ‘a more favourable urodynamic profile’ [translation: the flow is stronger] which helps ward off prostate problems. The study goes on to suggest that when we stand, we activate muscles around our lower abdomen, pelvis and spine that actually prevent proper urination.

Is it better to urinate while standing or sitting when you have urinary complaints?

The research above is about healthy men, however men with urinary complaints can find benefits of sitting over standing. The complaints are usually caused by an enlarged prostate. The complaints can be:

  • difficulty starting urination
  • a weak stream which makes urinating take longer
  • the bladder not emptying.

Also, an enlarged prostate can be the cause of frequent urination, difficulty in controlling urination and often having to go out at night to urinate.

Benefits of sitting while urinating

When urinating while sitting, the pelvic floor muscles relax better than when standing still and urinating generally lasts longer. This allows the bladder to empty better. Urodynamic research on men with urinary complaints shows that the jet is more powerful and that the bladder is emptied better when people urinate while sitting. However, the differences are small.

Concluding

In summary, you could say that sitting while urinating seems to be slightly better than standing for men with urinary problems. This has also been confirmed by reliable research. However, the differences are small and measurements were taken in the hospital and not in the daily situation, which can influence the outcomes. The takeaway advice, if you are facing urinary problems, try to sit while urinating and see if this decreases the symptoms.

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