Through The Zipper or Pants Down: Does It Change Uroflowmetry Parameters in Males?

Dönmez M1, Kocalar M1, Sezgin T1, Bayraktar A1, Hamarat M1, Sümer A1, Sahin E1, Ünlü M1, Kocalar M2, Gönen M1

Research Type


Abstract Category

Male Lower Urinary Tract Symptoms (LUTS) / Voiding Dysfunction

Abstract 219
Male Lower Urinary Tract Symptoms 1
Scientific Podium Short Oral Session 11
Wednesday 4th September 2019
17:00 - 17:07
Hall K
Male Prospective Study Voiding Dysfunction
1.Konya Training and Research Hospital, 2.Konya Numune Hospital

Muhammet Irfan Dönmez



Hypothesis / aims of study
There has been no studies to date comparing two different voiding practices (voiding through the zipper vs. pants down) in males. The aim of this study is to evaluate if voiding through the zipper or voiding pants down would make any difference with regard to uroflowmetry parameters and post voiding residual urine (PVR) volumes in healthy males with no lower urinary tract symptoms (LUTS). (Figure 1)
Study design, materials and methods
Healthy males over 18 years of age with no LUTS were prospectively evaluated using a uroflowmetry test. Each individual was asked to void through the zipper (group 1) and pants down (group 2) at different times. Uroflowmery test was repeated if voided volume did not exceed 150 ml. Uroflowmetry results such as voided volume, maximum flow rate (Qmax), average flow rate (Qave) and duration of voiding were noted. PVR volume was assessed using ultrasonography. Electromyography was not used. Data were shown as mean ± standard deviation. For statistical analysis, paired t test was used to analyze parametric parameters.
A total of 44 males were enrolled. Median age of individuals was 24 (range 18 - 44 years). There were no statistically significant differences between two measurements in terms of voided volumes (307 ± 121ml vs. 325 ± 145ml, p=0.365) and duration of voiding (25 ± 11 s vs 23.8 ± 11.6 s, p=0.526). However, there was statistically significant differences in Qmax (26.6 ± 6.7 ml/s vs. 30.0 ± 8.2 ml/s, p=0.001), Qave (14.4 ± 3.6 ml/s vs.16.2 ± 5.1ml/s, p=0.009) and PVR volumes (23.9 ± 19.4 ml vs. 3.9 ± 9.6 ml, p=0.0001). Table 1 summarizes comparative results.
Interpretation of results
Results of our preliminary prospective trial indicated a statistically significant PVR rise when healthy males with no LUTS void through the zipper when compared to pants down. In addition, a significant decrease in Qmax and Qave values were observed. Median age of our cohort was 24 years of age, nevertheless simple voiding practices were shown to alter uroflowmetry parameters. Clinical impact of this change remains unclear in this age group, though, in males with mild symptoms, practice of voiding might be questionned. Even more, this might have a prominent clinical utility in older patients.
Concluding message
A change in practice of voiding may influence male uroflowmetry parameters significantly in individuals with no LUTS. Future studies with increased number of individuals (including those with LUTS) and a broader age range cohort is required for solid conclusions.
Figure 1 Figure 1
Figure 2 Table 1
Funding None Clinical Trial No Subjects Human Ethics Committee Necmettin Erbakan University Faculty of Medicine Helsinki Yes Informed Consent Yes