Sit or Stand: How Should Men Pee?

Sit or Stand: How Should Men Pee?
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In 2012, Viggo Hansen, a substitute member of the Sörmland County Council in central Sweden, made global headlines when he proposed a motion requiring men on the council to sit while urinating when using the office restrooms. Hansen argued that sitting would leave the toilets much cleaner, and also claimed that sitting reduces the risk of prostate cancer and endows men with a more robust sex life.

It's difficult to dispute Hansen's first point, but a new systematic review and meta-analysis published to PLoS ONE sheds a stream of light on his second.

Researchers in the Department of Urology at Leiden University Medical Center in the Netherlands pooled and analyzed eleven studies comparing the effects of sitting versus standing on three key "urodynamic parameters": maximum flow rate, voiding time (the time that it takes to pee), and post-void residual volume (the amount of urine remaining in the bladder).

In healthy men, the team found no differences across any of the variables. Sitting was no better than standing for urinary health. However, the meta-analysis showed that men with lower urinary tract symptoms (LUTS) were able to empty their bladders more completely (see figure below), leaving 25 fewer milliliters of urine in their bladders. Men with LUTS also had a stronger flow and took 0.62 seconds shorter to urinate, but these two results were just shy of statistical significance.

LUTS affects approximately 40% of older men and encompasses symptoms like increased urinary frequency, painful urination, and incomplete emptying of the bladder. The most common cause is a benign increase in the size of the prostate.

In light of the evidence, the researchers recommend that men with LUTS consider peeing in the sitting position. Residual urine in the bladder is associated with increased prevalence of bladder stones and urinary tract infection, and men with LUTS are better able to empty their bladders.

But contrary to the arguments of Leftists in Sweden, a quick search of PubMed yields no evidence whatsoever that sitting is associated with reduced risk of prostate cancer or a better sex life. There doesn't appear to be any direct health-related reason for healthy men to pee sitting down.

Source: de Jong Y, Pinckaers JHFM, ten Brinck RM, Lycklama à Nijeholt AAB, Dekkers OM (2014) Urinating Standing versus Sitting: Position Is of Influence in Men with Prostate Enlargement. A Systematic Review and Meta-Analysis. PLoS ONE 9(7): e101320. doi:10.1371/journal.pone.0101320

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