Original Articles

The effect of standing and sitting voiding position on uroflowmetric findings and postvoiding residual volume in men with Benign Prostatic Hyperplasia (BPH)

Robin Kurnia Wijaya , Khoirul Kholis, Syarif Syarif, Muhammad Asykar Ansharullah Palinrungi, Syakri Syahrir, Andi Alfian

Robin Kurnia Wijaya
Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia.. Email: robinkurnia@yahoo.com

Khoirul Kholis
Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia.

Syarif Syarif
Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia.

Muhammad Asykar Ansharullah Palinrungi
Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia.

Syakri Syahrir
Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia.

Andi Alfian
Department of Public Health, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia.
Online First: December 10, 2020 | Cite this Article
Wijaya, R., Kholis, K., Syarif, S., Palinrungi, M., Syahrir, S., Alfian, A. 2020. The effect of standing and sitting voiding position on uroflowmetric findings and postvoiding residual volume in men with Benign Prostatic Hyperplasia (BPH). Indonesia Journal of Biomedical Science 15(1): 1-4. DOI:10.15562/ijbs.v15i1.247


Background: Some studies proposed that different voiding position can affect voiding quality in men with benign prostatic hyperplasia (BPH). It is said that a particular voiding position can provide better uroflowmetric findings and less post-void residual volume (PVR) in men with BPH. This study aimed to analyze the effect of the two most common voiding positions (standing and sitting) on uroflowmetric findings and PVR in men with BPH to make a recommended voiding position for men with BPH.

Methods: In this cross-sectional study, 36 men with symptomatic BPH were enrolled. The uroflowmetric study was done for each subject in 2 positions: standing and sitting. The following uroflowmetric parameters were studied: maximum flow rate (Qmax), time to maximum flow, average flow rate (Qave), and voiding time. PVR was assessed after each test. Data were analyzed by SPSS version 23 for Windows.

Results: The mean Qmax was significantly better in sitting than a standing position (11.106±4.7801 mL/s vs. 9.536±5.3374 mL/s; p=0.018); the mean Qave, time to maximum flow, and PVR were not different between 2 positions. The mean for Qave for standing and sitting positions were 5.014±2.9888 mL/s and 5.508±2.4437 mL/s in, (p=0.058), the mean voiding time were 43.08±7.980 seconds and 40.22±9.897 seconds, respectively (p= 0.31), and the meantime to maximum flow was 12.39±7.454 seconds and 10.06±4.610 seconds, respectively (p=0.192). In contrast, mean PVR was 87.28±44.810 mL and 72.53±42.779 mL, respectively (p=0.091).

Conclusion: The result of this study showed that sitting position had better Qmax than standing position. Incorporating a sitting position with other BPH management might give a synergistic effect that improves urinary flow in men with BPH.

References

Goel A, Kanodia G, Sokhal AK, Singh K, Agrawal M, Sankhwar S. Evaluation of Impact of Voiding Posture on Uroflowmetry Parameters in Men. World J Mens Health. 2017;35(2):100-106.

Salem T, Abbas H, Ali M, Al Robigi A. The effect of voiding position on uroflowmetry findings and postvoiding residual urine in patients with benign prostatic hyperplasia. Urol Today Int J. 2009;2(3):5-7.

de Jong Y, Pinckaers JH, ten Brinck RM, Lycklama à Nijeholt AA, Dekkers OM. Urinating standing versus sitting: position is of influence in men with prostate enlargement. A systematic review and meta-analysis. PLoS One. 2014;9(7):e101320.

Yazici CM, Turker P, Dogan C. Effect of voiding position on uroflowmetric parameters in healthy and obstructed male patients. Urol J. 2014;10(4):1106-1113.

Choudhury S, Agarwal MM, Mandal AK, Mavuduru R, Mete UK, Kumar S, Singh SK, et al. Which voiding position is associated with lowest flow rates in healthy adult men? role of natural voiding position. Neurourol Urodyn. 2010;29(3):413-417.

El-Bahnasawy MS, Fadl FA. Uroflowmetric differences between standing and sitting positions for men used to void in the sitting position. Urology. 2008;71(3):465-468.

Unsal A, Cimentepe E. Voiding position does not affect uroflowmetric parameters and post-void residual urine volume in healthy volunteers. Scand J Urol Nephrol. 2004;38(6):469-471.

Gleason DM, Bottaccini MR, Drach GW. Urodynamics. J Urol. 1976;115(4):356-361.

Roehrborn CG. Male lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Med Clin North Am. 2011;95(1):87-100.

Thapa N, Agrawal CS. Correlation of uroflowmetry with lower urinary tract symptoms in patients with symptomatic benign prostatic hyperplasia at eastern part of Nepal: A prospective study. IOSR-J Dental Med Sci. 2017;16(1):86-91.

Dicuio M, Pomara G, Menchini Fabris F, Ales V, Dahlstrand C, Morelli G. Measurements of urinary bladder volume: comparison of five ultrasound calculation methods in volunteers. Arch Ital Urol Androl. 2005;77(1):60-62.

Aghamir SM, Mohseni M, Arasteh S. The effect of voiding position on uroflowmetry findings of healthy men and patients with benign prostatic hyperplasia. Urol J. 2005;2(4):216-221.

Eryıldırım B, Tarhan F, Kuyumcuoğlu U, Erbay E, Pembegül N. Position-related changes in uroflowmetric parameters in healthy young men. Neurourol Urodyn. 2006;25(3):249-251.

Barry MJ, Fowler FJ Jr, O'leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The American Urological Association Symptom Index for Benign Prostatic Hyperplasia. J Urol. 2017;197(2S):S189-S197.

Roehrborn CG, Kaplan SA, Lee MW, Slawin KM, McVary KT, Kusek JW, Nyberg LM. 1638: Baseline Post Void Residual Urine Volume as a Predictor of Urinary Outcomes in Men with BPH in the MTOPS Study. The Journal of Urology. 2005;173(4):443-444.

Singla S, Garg R, Singla A, Sharma S, Singh J, Sethi P. Experience with uroflowmetry in evaluation of lower urinary tract symptoms in patients with benign prostatic hyperplasia. J Clin Diagn Res. 2014;8(4):NC01-NC3.

Duarsa GWK, Lesmana RL, Mahadewa TGB. High Serum Prostate Specific Antigen as A Risk Factor for Moderate-Severe Prostate Inflammation in Patient with Benign Prostatic Hyperplasia. Bali Medical Journal. 2016;4(3):148-151.


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