title: Urinating standing versus sitting: position is of influence in men with prostate enlargement. A systematic review and meta-analysis.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Urology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
authors: Ype
authors: Y
authors: de Jong
authors: Department of Urology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
authors: Johannes Henricus Francisca Maria
authors: JH
authors: Pinckaers
authors: Department of Urology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
authors: Robin Marco
authors: RM
authors: ten Brinck
authors: Department of Urology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
authors: Augustinus Aizo Beent
authors: AA
authors: Lycklama à Nijeholt
authors: Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
authors: Olaf Matthijs
authors: OM
authors: Dekkers
mesh_terms: D016022:Case-Control Studies; D006801:Humans; D008297:Male; D011187:Posture; D011470:Prostatic Hyperplasia / Q000503:physiopathology*; D014554:Urination; D014563:Urodynamics