{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T07:16:38Z","timestamp":1787987798397,"version":"build-2784847793"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T00:00:00Z","timestamp":1681430400000},"content-version":"am","delay-in-days":365,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#am"},{"start":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T00:00:00Z","timestamp":1649894400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009029","name":"Adaptable and Seamless Technology Transfer Program through Target-Driven R and D","doi-asserted-by":"publisher","award":["JPMJTM20FN"],"award-info":[{"award-number":["JPMJTM20FN"]}],"id":[{"id":"10.13039\/501100009029","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["17K10164"],"award-info":[{"award-number":["17K10164"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Few studies have examined the effects of body position on urination efficiency morphologically. We aimed to dissect out the anatomical changes of pelvic organs during urination in the upright and supine positions by a real\u2010time magnetic resonance imaging (rtMRI) system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirteen healthy male volunteers aged 26\u201360 years were included in the study. The sagittal real\u2010time two\u2010dimensional images were taken to evaluate urinary efficiency, along with change in six morphological indices at the time of storage and the beginning of voiding, in both upright ant supine positions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Urination was more efficient in upright position than in supine position, as expressed by higher average rate of bladder emptying (9.9\u2009\u00b1\u20094.2 vs. 6.8\u2009\u00b1\u20092.9\u2009ml\/s, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) and also by fewer participants showing significant residual urine (1\/13 vs. 7\/13, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). At the onset of voiding in standing position, the levator ani (LA) muscle moves downward and backward followed by descent of the bladder neck and rotation of the prostate around the symphysis. Such changes were expressed by two morphological indices. One was posterior vesicourethral angle at the start of voiding, 152\u2009\u00b1\u20097 versus 140\u2009\u00b1\u20091 in upright and supine position (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The other index was the change in angle between the LA line and pubo\u2010coccygeal line in upright and supine position, 9.4\u2009\u00b1\u20099.9 versus 1.6\u2009\u00b1\u20097.9 before voiding (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) and 30.2\u2009\u00b1\u200914.0 versus 17.3\u2009\u00b1\u200912.9 after the start of voiding (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The dynamic relaxation of LA seemed to be a key movement that enables more efficient urination in standing position than in supine position.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.24930","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T08:54:07Z","timestamp":1649926447000},"page":"1074-1081","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Why upright standing men urinate more efficiently than in supine position: A morphological analysis with real\u2010time magnetic resonance imaging"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4611-5706","authenticated-orcid":false,"given":"Kimihiro","family":"Shimatani","sequence":"first","affiliation":[{"name":"Department of Urology Hyogo College of Medicine Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0819-966X","authenticated-orcid":false,"given":"Mazen","family":"Soufi","sequence":"additional","affiliation":[{"name":"Division of Information Science Graduate School of Science and Technology, Nara Institute of Science and Technology Ikoma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6199-3681","authenticated-orcid":false,"given":"Yoshinobu","family":"Sato","sequence":"additional","affiliation":[{"name":"Division of Information Science Graduate School of Science and Technology, Nara Institute of Science and Technology Ikoma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6032-0557","authenticated-orcid":false,"given":"Shingo","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Urology Hyogo College of Medicine Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2534-9933","authenticated-orcid":false,"given":"Akihiro","family":"Kanematsu","sequence":"additional","affiliation":[{"name":"Department of Urology Hyogo College of Medicine Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1402289111"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2005.01.012"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1590\/s1677-5538.ibju.2015.0450"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1520-6777(1999)18:6<553::AID-NAU5>3.0.CO;2-Y"},{"issue":"1","key":"e_1_2_11_6_1","first-page":"71","article-title":"Real\u2010time interactive MR imaging system: sequence optimization, and basic and clinical evaluations","volume":"18","author":"Naganawa S","year":"2000","journal-title":"Radiat 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