Editorial Comment

Abstract

This is a novel experiment comparing the urinary flow rate parameters in varying positions in both boys and girls to determine the optimal position for urinating. The differences in some flow rate parameters were significantly different for each of the positions assumed by the children as they emptied their bladder, with girls having a greater peak flow rate and detrusor pressure at the peak urinary flow rate (Qmax) in the sitting position, and boys doing better in the standing position. Overall, girls had a greater Qmax and lower detrusor pressure at Qmax than boys, suggesting that girls void with lower pressure to achieve a greater flow rate than boys, possibly because of lower bladder outlet resistance. In addition, the free flow void (without a catheter) Qmax was greater than with a catheter in both sexes. The authors postulate that the catheter itself, however small, might be obstructive, or its presence might induce some tightening of the external urethral sphincter muscle during the study.