November 3, 2026, 4:48 pm | Read time: 5 minutes
From a hygiene perspective, the recommendation for men might be to urinate while sitting. However, beyond such and cultural aspects, health could also play a role in the decision. Several scientific studies have already explored whether body posture affects urine flow. So far, they have yielded inconsistent results. A new study aimed to find clear answers and also examined whether any deviations are medically significant. It should be noted upfront: Uncertainties remain. Therefore, FITBOOK also consulted an independent expert to see if he recommends urinating while standing or sitting.
Urine Flow Is an Important Indicator of Health
The speed at which urine flows during urination can provide insights into urinary tract health, specifically potential dysfunctions. For instance, an enlarged prostate can narrow the urethra and thus impede urine flow. Those affected often notice this through a delayed start to urination and a weak or interrupted stream.
There is a method to measure urine flow: uroflowmetry.1 The devices used in this process record, among other things, how quickly and over what period urine is expelled. An important measurement is the maximum urine flow rate (Qmax), which indicates how many milliliters of urine are expelled per second at most. The total volume of urine expelled and the time to reach the maximum urine flow rate (tQmax) are other key parameters.
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How Does Posture Affect Urine Flow?
The current study posed the question of whether body posture during urination could influence these measurements.2 The focus was on comparing uroflowmetry values when urinating standing versus sitting, particularly whether the maximum urine flow rate differs between the two positions.
Previous studies have delivered inconsistent results in this context, the authors write. For example, a study with 740 men showed no significant differences between the two positions in men up to 50 years old.3 In older men, however, the residual urine volume was lower when sitting, while the duration of urination increased. The maximum and average urine flow rates remained unchanged.
Against this backdrop of unresolved questions, the authors of the study presented here wanted to examine more closely whether differences between the two positions can be detected in healthy men and whether these are medically relevant.
Study Details
This was a prospective, randomized crossover study, meaning all participants had to undergo both test conditions. This design allows for comparing results within the same person.
A total of 52 generally healthy men participated in the study. The age of the participants is not specified in the abstract. The men were randomly assigned to one of two groups, differing only in the order of the test conditions. The first group of 24 participants was to urinate sitting first and then standing. The 28 participants in the second group did the opposite. There was a washout phase of about 24 hours in between to prevent the results of the second test from being influenced by the posture in the first test.
Focus on Measurements
The researchers considered both the maximum urine flow rate (Qmax), the total volume of urine expelled, and the time to reach the highest urine flow (tQmax).
For the analysis, they used various statistical methods, including so-called linear mixed models and a Bayesian analysis. The latter is a method that combines existing knowledge with new data to update the probability of a hypothesis, for example.
A unique aspect of the study was an additional so-called equivalence analysis. It aimed to determine whether the results of both postures are close enough to be considered equivalent. Using the TOST equivalence test, the researchers examined whether the maximum urine flow rate differs by no more than 2.5 milliliters per second between sitting and standing.
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Results and Their Significance
The authors found no statistically significant difference in the maximum urine flow rate between urinating while sitting and standing. The measured difference was −1.47 milliliters per second, which was minimal. Similarly, there were no statistically significant differences in the total volume of urine expelled (the difference was 14.7 milliliters).
However, they found significant differences in the time to reach the maximum urine flow. Participants took an average of 3.32 seconds longer to reach the highest urine flow while standing than while sitting. Even after correcting for potential biases from multiple statistical tests, the result held. The supplementary Bayesian analysis also supported the finding. However, there were moderate indications that the two positions did not differ in the volume of urine expelled.
In summary, body posture during urination in healthy men does not seem to significantly affect the maximum urine flow rate or the volume of urine expelled. Only the time to reach the maximum urine flow showed a statistically significant difference. However, the authors emphasize that its medical significance is questionable. A scientifically validated recommendation for urinating while sitting or standing cannot be derived from the observations. Whether one of the two positions offers advantages to men with urination issues must be clarified by further, larger studies with appropriate participant groups, according to the researchers.
Study Limitations
The sample size of the study was relatively small, with 52 participants. This is particularly relevant for proving equivalence, as a larger number of participants might have been necessary.
Another limitation concerns the time to maximum urine flow. Although the difference remained statistically significant, the result was partly dependent on a single outlier, which diminishes its significance. Additionally, only healthy men were studied. Therefore, the results cannot be readily applied to men with urinary tract issues or diseases.
The authors therefore recommend larger, pre-registered studies with a predetermined equivalence analysis and the inclusion of men with relevant issues.