*4.4.1.5 Optimal bladder emptying*

The position when urinating has a significant effect on the ability to empty the bladder. Toilet bowls are intended for adults and as such are not suitable for children. Relaxation of the PFMs is difficult or impossible with various irregular positions that the child assumes during urination.

Proper voiding position means urinating in a sitting position on the toilet bowl for girls and boys. For smaller children, it is important to require the use of an adequate toilet seat insert and footrests to ensure trunk stability [26]. When urinating, the child should be slightly bent forward, with the spine in extension, the hips in abduction and the relaxed abdominal muscles (**Figure 3**). It is necessary for children to listen to the sound of the stream when urinating and the goal is for the stream to be strong, long and sonorous.
