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The influence of positioning in urination: an electromyographic and uroflowmetric evaluation
Paulo Sampaio Furtado1, Patrícia Lordêlo2, Daniela Minas2
1Division of Urology, Pediatric Urology Sector, Center for Voiding Disorders of Children (CEDIMI), Bahiana School of Medicine and Public Health (EBMSP), Federal University of Bahia, Salvador, Brazil; Federal University of Bahia, Salvador, Brazil.
Insights
Children with lower urinary tract dysfunction (LUTD) may benefit from specific urination postures. Atypical positions increased perineal electrical activity in girls, suggesting posture is important for pelvic floor function.
Area of Science:
- Pediatric Urology
- Pelvic Floor Electrophysiology
- Urodynamics
Background:
- Lower urinary tract dysfunction (LUTD) affects children, potentially influenced by voiding habits.
- Understanding the impact of posture on urination mechanics is crucial for effective management.
Purpose of the Study:
- To investigate if different urination positions affect abdominal and perineal muscle electrical activity in children with LUTD.
- To assess the influence of posture on uroflowmetric parameters in this pediatric population.
Main Methods:
- A cross-sectional study involving 94 children (ages 3-14) with LUTD symptoms.
- Electromyography (EMG) and uroflowmetry were performed in both standard and atypical urination positions.
- Data from nine excluded patients were removed due to interference or chart analysis complications.
Main Results:
- Children in atypical positions exhibited significantly higher perineal electrical activity compared to standard positions (p=0.018).
- No significant differences in uroflowmetric curve patterns were observed between positions (p=0.824).
- Boys showed no significant differences in perineal or abdominal electrical activity between positions.
Conclusions:
- Female children with LUTD demonstrated decreased pelvic floor muscle electrical activity in the standard position versus atypical positions.
- Adequate posture during urination warrants consideration for girls diagnosed with LUTD.
Purpose:
We conducted a cross-sectional study to evaluate whether the different positions during urination influence the electrical activity of the abdominal and perineal musculature, as well as the uroflowmetric parameters of children with lower urinary tract dysfunction (LUTD).
Materials And Methods:
Ninety-four children between the ages of 3 and 14 years with symptoms of LUTD were evaluated. All underwent uroflowmetry and electromyography tests (abdominal and perineal) in two different positions: oriented position (trunk bent slightly forward and feet flat) and atypical position (standing on toes for boys and buttocks not in contact with the lavatory seat and legs flexed in girls). We excluded nine patients due to suspicions of outside interference or elements complicating the analysis of charts.
Results:
Among patients evaluated 55 (64.7%) were girls and 30 (35.3%) were boys with an average age of 8.5 years. Children urinating in atypical position showed higher levels of perineal electrical activity than when they were in normal position (p=0.018). However, there was no difference in the pattern of the curve if normal or abnormal when comparing the two groups (p=0.824). When evaluated separately, the boys demonstrated no difference between positions, in relation to perineal electrical activity (p=0.412) or abdominal electrical activity (p=0.202).
Conclusions:
The electrical activity of the pelvic floor musculature is decreased in the oriented position when compared to atypical positions in female children. Our data suggest that special attention should be given to adopting an adequate posture during urination for girls with LUTD.
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