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.