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Does it matter for men (and pharma companies) whether they sit or stand?

dekkersA new Dutch study on an old question — should men stand or sit when urinating? — just might weaken the revenue stream of pharma companies that offer treatments for male urinary ailments.

The researchers suggest (that is their word) that altering a man’s stance when urinating can sometimes be effective at treating some prostate-related (and similar) problems. Sometimes as effective, even, as treating the man with drugs.

The study, called “Urinating Standing versus Sitting: Position Is of Influence, in Men with Prostate Enlargement. A Systematic Review and Meta-Analysis,” was published in PLoS ONE, 9(7), 2014, e101320. Authors Ype de Jong, Johannes Henricus Francisca Maria Pinckaers, Robin Marco ten Brinck, Augustinus Aizo Beent Lycklama à Nijeholt, Olaf Matthijs Dekkers [pictured here] are at Leiden University Medical Center.

void-for-men-image

The team did a meta-analysis of previous studies that touch on those ailments. Their study of those studies says:

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 healthy participants, no clear differences were found in any of the measured parameters for sitting versus standing position….

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.

They add this kicker — a message to deliver directly to patients  — at the very end of the report:

We conclude that the sitting posture is the best position for men with urination problems, e.g. due to an enlarged prostate to urinate in, whereas no difference was found in healthy men. This is clinically important, because residual urine may result in complications such as cystitis and bladder stones.

On recommending posturing versus medication, the Leiden study takes a traditionally cautious, don’t-overtly-rock-the-boat-except-ever-so-gently approach:

It is intriguing that the effect of changing to a sitting voiding posture – a simple intervention without any serious side effects – approaches the effect of conventional pharmacological treatment of LUTS. However, it  should not be regarded as the sole therapy instead of pharmacological treatment, perhaps both interventions combined could have a synergistic effect on urodynamics in the management of LUTS.

The next step, if there is to be one, would be to compare two groups of ailing men  — one group treated with pharmaceuticals, the other instead instructed to sit (or otherwise alter their stance so as to readjust their plumbing). The comparison could be extended, too, to include surgical intervention versus the other alternatives.

The university offers a press release (in Dutch) with a few additional details.

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