Crouching over the toilet seat: prevalence among British gynaecological outpatients and its effect upon micturition
Abstract
Summary. This study investigated whether British women prefer to crouch over public toilet seats, and measured the effect of such a voiding position on urine flow rate and residual urine volume. Of 528 consecutive women who attended a general gynaecological clinic and completed an anonymous questionnaire, 85% usually crouched over the toilet when using a public convenience, 12% applied paper to the seat and 2% sat directly on public toilet seats. When using a friend's bathroom 38% of the women voided by crouching. Results were similar for 155 patients attending a urodynamic clinic, 80 of whom were studied while voiding in both positions. There was a 21% reduction in average urine flow rate and a 149% increase in residual urine volume in the crouching position. Women undergoing urodynamic tests should be asked which voiding position they used before abnormal results are interpreted. Patients with a reduced functional bladder capacity may benefit from being encouraged to sit comfortably on the toilet whenever possible.
Citing Literature
Number of times cited according to CrossRef: 38
- Kimberly J. Angelini, Diane K. Newman, Mary H. Palmer, Psychometric Evaluation of the Toileting Behaviors, Female Pelvic Medicine & Reconstructive Surgery, 10.1097/SPV.0000000000000711, 26, 4, (270-275), (2020).
- Aeyoung So, Jennie C. De Gagne, Sunah Park, Validity and Reliability of the Korean Version of the Women’s Toileting Behavior Scale, International Neurourology Journal, 10.5213/inj.1938018.009, 23, 2, (151-160), (2019).
- Omar Felipe Dueñas-Garcia, Maria del Pilar Matta-Gonzalez, Kylie Fuller, Wei Fang, Robert Edward Shapiro, The Effect of Toileting Position in Uroflow Curves in Young Healthy Nulliparous Women, Scientifica, 10.1155/2019/5273083, 2019, (1-4), (2019).
- Adam M Daily, Casey G Kowalik, Sophia D Delpe, Melissa R Kaufman, Roger R Dmochowski, W Stuart Reynolds, Women with overactive bladder exhibit more unhealthy toileting behaviors: a cross-sectional study, Urology, 10.1016/j.urology.2019.08.038, (2019).
- Apul Goel, Gautam Kanodia, Ashok Kumar Sokhal, Kawaljit Singh, Monica Agrawal, Satyanarayan Sankhwar, Evaluation of Impact of Voiding Posture on Uroflowmetry Parameters in Men, The World Journal of Men's Health, 10.5534/wjmh.2017.35.2.100, 35, 2, (100), (2017).
- Johanna Sjögren, Lars Malmberg, Karin Stenzelius, Toileting behavior and urinary tract symptoms among younger women, International Urogynecology Journal, 10.1007/s00192-017-3319-2, 28, 11, (1677-1684), (2017).
- Agnès Thépaut, Ce que l’humour peut pour la santé des femmes, Vocation Sage-femme, 10.1016/j.vsf.2017.05.001, 16, 127, (1), (2017).
- Susan E. George, Diane F. Borello-France, Perspective on Physical Therapist Management of Functional Constipation, Physical Therapy, 10.2522/ptj.20160110, 97, 4, (478-493), (2016).
- C Greed, The role of the public toilet: pathogen transmitter or health facilitator?, Building Services Engineering Research and Technology, 10.1191/0143624406bt151oa, 27, 2, (127-139), (2016).
- Julia Edwards, Linda McKie, A Serious Issue for the Body Politic, European Journal of Women's Studies, 10.1177/135050689600300303, 3, 3, (215-230), (2016).
- Y. de Jong, J.H.F.M. Pinckaers, R.M. ten Brinck, A.A.B. Lycklama à Nijeholt, Invloed van mictiehouding op urodynamische parameters bij mannen: een literatuuronderzoek, Tijdschrift voor Urologie, 10.1007/s13629-014-0008-5, 4, 1, (36-42), (2014).
- Selçuk Yüksel, Ayşe Çolpan Yurdakul, Mehmet Zencir, Nergül Çördük, Evaluation of lower urinary tract dysfunction in Turkish primary schoolchildren: An epidemiological study, Journal of Pediatric Urology, 10.1016/j.jpurol.2014.05.008, 10, 6, (1181-1186), (2014).
- Ype de Jong, Johannes Henricus Francisca Maria Pinckaers, Robin Marco ten Brinck, Augustinus Aizo Beent Lycklama à Nijeholt, Olaf Matthijs Dekkers, Urinating Standing versus Sitting: Position Is of Influence in Men with Prostate Enlargement. A Systematic Review and Meta-Analysis, PLoS ONE, 10.1371/journal.pone.0101320, 9, 7, (e101320), (2014).
- Ajay Rane, Jay Iyer, Posture and micturition: does it really matter how a woman sits on the toilet?, International Urogynecology Journal, 10.1007/s00192-013-2284-7, 25, 8, (1015-1021), (2013).
- Thi Kim Anh Nguyen, Susan J. Vernon, Ann Bengtson, Anna-Lena Hellström, Toilet habits in kindergarten children in a kindergarten in Hanoi, Health, 10.4236/health.2013.511237, 05, 11, (1760-1767), (2013).
- Ricarda M. Bauer, Wilhelm Huebner, Gender differences in bladder control: from babies to elderly, World Journal of Urology, 10.1007/s00345-013-1132-1, 31, 5, (1081-1085), (2013).
- X. Deffieux, Gérard Amarenco, Agnès Senéjoux, Usage des toilettes chez les jeunes filles : tabous, us et coutumes, Pathologies des toilettes, 10.1007/978-2-8178-0356-2, (9-14), (2013).
- X. Deffieux, Gérard Amarenco, Agnès Senéjoux, Les toilettes et la physiologie de la poussée, Pathologies des toilettes, 10.1007/978-2-8178-0356-2, (15-19), (2013).
- Jan Schapper, The writing is on the wall: the text(ure) of women's toilets in Australia, Gender, Place & Culture, 10.1080/0966369X.2011.610094, 19, 4, (494-517), (2012).
- X. Deffieux, T. Thubert, Urogynécologie et usage des sanitaires chez la petite filleUrogynecology and use of the toilets by the little girls, Pelvi-périnéologie, 10.1007/s11608-011-0378-6, 6, 3-4, (188-191), (2011).
- Kefang Wang, Mary H. Palmer, Development and Validation of an Instrument to Assess Women's Toileting Behavior Related to Urinary Elimination, Nursing Research, 10.1097/NNR.0b013e3182159cc7, 60, 3, (158-164), (2011).
- Mohsen Amjadi, Sakineh Hajebrahimi, Farzin Soleimanzadeh, The Effect of Voiding Position on Uroflowmetric Parameters in Healthy Young Men, UroToday International Journal, 10.3834/uij.1944-5784.2011.06.06, 04, 03, (2011).
- Eric Chieh-Lung Chou, Pei-Yu Yang, Wen-Hui Hsueh, Chao-Hsiang Chang, Nai-Hsin Meng, Urinating in the Standing Position: A Feasible Alternative for Elderly Women With Knee Osteoarthritis, Journal of Urology, 10.1016/j.juro.2011.04.058, 186, 3, (949-953), (2011).
- Rashel Haverkorn, Jason Gilleran, Philippe Zimmern, Pressure–Flow Plot in the Evaluation of Female Incontinence and Postoperative Obstruction, Textbook of Female Urology and Urogynecology, Third Edition, 10.3109/9781439807217, (276-289), (2010).
- A. Bortolami, Riabilitazione del pavimento pelvico per i sintomi del basso tratto urinario, EMC - Medicina Riabilitativa, 10.1016/S1283-078X(10)70197-8, 17, 4, (1-20), (2010).
- Kai-Ning Yang, Shu-Chen Chen, Shu-Yueh Chen, Chao-Hsiang Chang, Hsi-Chin Wu, Eric Chieh-Lung Chou, Female voiding postures and their effects on micturition, International Urogynecology Journal, 10.1007/s00192-010-1204-3, 21, 11, (1371-1376), (2010).
- A. Rane, A. Corstiaans, Does micturition improve in the squatting position?, Journal of Obstetrics and Gynaecology, 10.1080/01443610802044726, 28, 3, (317-319), (2009).
- Magdy S. EL-Bahnasawy, Fahd A. Fadl, Uroflowmetric Differences Between Standing and Sitting Positions for Men Used to Void in the Sitting Position, Urology, 10.1016/j.urology.2007.11.011, 71, 3, (465-468), (2008).
- Narmada P. Gupta, Atul Kumar, Rajeev Kumar, Does Position Affect Uroflowmetry Parameters in Women?, Urologia Internationalis, 10.1159/000111727, 80, 1, (37-40), (2008).
- Gilles Karsenty, Benjamin Coquet-Reinier, Ehab Elzayat, Marie-Claude Lemieux, Jacques Corcos, P-Mate™, a new device allowing women to urinate in the standing position: urodynamic and satisfaction assessment, International Urogynecology Journal, 10.1007/s00192-007-0536-0, 19, 6, (823-826), (2008).
- Nihat Uluocak, Tayfun Oktar, Omer Acar, Olga İncesu, Orhan Ziylan, Unal Erkorkmaz, Positional Changes in Voiding Dynamics of Children with Non-Neurogenic Bladder Dysfunction, Urology, 10.1016/j.urology.2008.02.067, 72, 3, (530-534), (2008).
- Barbro Lundblad, Marie Berg, Anna-Lena Hellström, Experiences of children treating functional bladder disturbances on schooldays, Journal of Pediatric Urology, 10.1016/j.jpurol.2006.08.004, 3, 3, (189-193), (2007).
- J Haslam, J Laycock, Voiding Problems, Therapeutic Management of Incontinence and Pelvic Pain, 10.1007/978-1-84628-756-5, (133-137), (2007).
- Annette Kuhn, Kathleen Vits, Peter Kuhn, Ash Monga, Do women with urinary incontinence really know where all the toilets are?, European Journal of Obstetrics & Gynecology and Reproductive Biology, 10.1016/j.ejogrb.2005.11.004, 129, 1, (65-68), (2006).
- J. Haslam, Bladder Training and Behavioural Therapy, Therapeutic Management of Incontinence and Pelvic Pain, 10.1007/978-1-4471-3715-3, (103-107), (2002).
- J. Haslam, Voiding Problems in Women, Therapeutic Management of Incontinence and Pelvic Pain, 10.1007/978-1-4471-3715-3, (109-112), (2002).
- Kate H. Moore, Conservative management for urinary incontinence, Best Practice & Research Clinical Obstetrics & Gynaecology, 10.1053/beog.1999.0074, 14, 2, (251-289), (2000).
- Kate H Moore, Detrusor Instability in Women Its Significance for Continence Therapists, Physiotherapy, 10.1016/S0031-9406(05)66999-4, 82, 1, (52-57), (1996).