Influence of Voiding patterns in LUTS/BPO

Dear All,

At many centres Uroflowmetry is routinely employed in the assessment of LUTS/BPO. However it is not clear in which position Uroflowmetry should be performed. In Urban areas of the country many men void in standing position while in Rural India, many adopt squatting position for voiding. At most Uroflowmetry assessments, either Standing or Sitting position is used and not the common squatting position. Barring studies from Iran, where squatting position is more frequent, and no other country has addressed this position while performing Uroflowmetry. There are studies that indicate that standing position should be preferred but there is equal number of studies indicating sitting position should be preferred. Both AUA and EAU Guidelines though mention Uroflowmetry as an essential tool does not address the preferred voiding position. I am providing few articles addressing the issue of voiding position for voiding and from which the different views can be observed.

Adel Alrabadi * et al (2020) published online on July 14th is the latest study on this aspect.

I am providing few more articles addressing both aspects ie, Standing or Sitting position for voiding (PDF available) (PDF available)

It is important to note that Uroflowmetry should be performed in a position the patient is accustomed to for obtaining satisfactory results be it be standing, sitting or squatting (the latter is not usually considered as a position for Uroflowmetry).

I find that Voiding in standing position has better flow than when voiding in sitting position. I am sure each one of us will have different views and mostly it is because we get accustomed to a particular position and naturally will find that position more useful.

I am sure our experts with considerable experience will add to which voiding position thay recommend at Uroflowmetry.

With warm Regards,




  • Ali Poonawala
    Ali Poonawala
    11 Nov 2020 01:26:06 PM

    My practice is to ask the patient which position s/he prefers, and allow the same, both, for free flow uroflowmetry as well as during Urodynamic study.

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