Our objective was to study whether the urinary flow rate would vary according to voiding position. Twenty‐one normal healthy male volunteers aged 24 to 40 years (mean, 29 years) were studied. The bed used was designed so that a hole could be opened at its center for voiding, and the bed could be bent at two points so that the subject could void in various positions. Urinary flow was measured with a portable uroflowmeter (P‐Flow), which permits measuring urinary flow rate. Each subject assumed five voiding positions (standing, sitting, lateral, supine, and prone) in random order. Urinary flow was measured at least twice in each position to record a stable voiding. For voiding in the lateral position, subjects were instructed to void while bending the upper leg to keep an open angle between the legs. All subjects were also instructed to void without increasing abdominal pressure. Maximum flow rate was 20.7 ± 6.59 mL/sec with voided volume of 262 ± 77.8 mL in the lateral, 22.1 ± 7.05 mLl/sec with voided volume of 309 ± 130 mL in the supine, 25.0 ± 8.25 mL/sec with voided volume of 287 ± 122 mL in sitting, 27.1 ± 8.89 mL/sec with voided volume of 263 ± 102 mL in the standing, and 28.7 ± 10.6 mL/sec with voided volume of 303 ± 98 mL (mean ± SD) in the prone positions. The maximum and mean urinary flow rates were greatest in the prone position. With regard to these parameters, significant differences were noted between the prone and lateral positions and between the prone and supine positions. In conclusions, the maximum urinary flow rate was highest in the prone position, followed by the standing, sitting, supine, and finally the lateral positions in normal males. Neurourol. Urodynam. 18:553–557, 1999. © 1999 Wiley‐Liss, Inc.

Bladder function was irreversible after spinal surgery, whereas urethral function showed a better recovery in patients with acute urinary retention due to central lumbar disc prolapse. However, most of our patients could empty their bladder only by straining or changing their voiding postures postoperatively.

Between April 1992 and May 1993, 13 patients (age, 66-79) with localized prostate cancer underwent laparoscopic pelvic lymphadenectomy at Asahi General Hospital. Clinical stage comprised A2 for 3 patients, B1 for 1 and C for 9. Lymphadenectomy covered inner half of external iliac nodes and obturator nodes, from pubic bone to proximal end of umbilical ligament. Operating time ranged from 70 minutes to 133 minutes with median of 102 minutes. The number of total lymph nodes dissected ranged from 3 to 17 nodes with median of 7. Lymph nodal involvement was detected in one patient. Two patients needed laparotomy due to bleeding; from abdominal wall caused at insertion of trocar in one, and oozing of blood for 10 hours after procedure in the other. Other serious complications were not observed. In conclusion, laparoscopic pelvic lymphadenectomy was a good staging procedure for localized prostate cancer.