Introduction
In a healthy person, below normal hydration levels, the body produces an
average of 1-2 liters of urine per day1. Most of the
urine production occurs during waking hours, and only 20-30% of urine
is produced during sleep1. Different factors have been
hypothesized to affect urine production or voiding physiology. It may be
due to internal and external factors that affect urine production. One
of the internal factors is age, as noted by Myron Miller, who studies
changes in the kidney and hormonal systems that control water and sodium
excretion2. Hoshiyama et al. suggest that elderly
patients show an increase in nocturnal urine production due to
natriuresis resulting from increased B-type natriuretic peptide (BNP)
secretion and decreased anti-diuretic hormone (ADH) secretion3. Denys et al. state that circadian rhythms of the
bladder and the kidney changes as patients grow older, the study found
that 96% of patients >65 years, who consulted for
complaints of UI, had nocturia 4.
Different external factors have been known to give a significant impact
on urine production. Fluid consumption is an example of such. Studies
showed that decreasing fluid intake in patients with detrusor activity
and/or urodynamic stress incontinence decreased voiding frequency,
urgency and incontinence episodes 5,6. Studies have
also shown an important impact of caffeine on urine production7,8. Besides caffeine and fluid intake, there is
increasing evidence to support the effect of carbonated drinks in the
development of lower urinary tract symptoms (LUTS) 8.
Robinson et al. performed a large population-based study based on the
Boston Area Community Health Survey which showed that an overall larger
intake of energy resulted in more urinary incontinence as well as
increased its severity. Furthermore, they demonstrated that an increase
in saturated fat was associated with post micturition symptoms and
nocturia 7.
In the literature, there is no study that investigates the impact of
movement, physical activity, and position on urine production. However,
we the authors, have, based on the physiology, a strong inclination to
believe that movement, physical activity, and position will have a
significant impact on urine production. Therefore, in this pilot study,
we aimed to investigate the effects of movement, physical activity, and
position on urine production.