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Falling toilet seats: Rare but growing risk for boys

By Andrew M. Seaman

NEW YORK (Reuters Health) - Ouch: Boys know that toilet seats are an occupational hazard of potty training, but a new study suggests the number of genital injuries caused by falling toilet toppers is growing.

Researchers found the number of emergency room visits for toilet-related injuries to the penis, while still rare, increased by about 100 visits each year between 2002 and 2010.

Usually, the injuries happen when boys are learning how to urinate into the toilet while standing up and the seat falls unexpectedly - although a few adults did get snagged by the seat, too.

"It's a toddler basically potty training who doesn't have the most advanced motor skills and they just don't have the reflexes to move fast enough," said Dr. Benjamin Breyer, the study's lead author from the University of California, San Francisco.

Previously, the researchers found that about 16,000 men and women are sent to U.S. emergency rooms (ERs) with genital injuries every year (see Reuters Health story of November 7, 2012 here: http://reut.rs/11KE7mL).

Breyer's team was "pretty surprised" to learn that one in 30 genitourinary injuries showing up to the ER involved toilets.

"To us, that was striking. That was unexpected. You think of the bathroom as a safe place," he said.

Using a national database of injuries caused by household products that were treated by U.S. ERs between 2002 and 2010, the researchers found 13,175 genital injuries related to the toilet or toilet seat.

About 68 percent were so-called crush injuries, which is when the penis gets trapped between the seat and the bowl. Of those, about 97 percent were in children seven years old and younger. Only five adults were caught by falling lids.

The researchers write in the journal BJU International that while these injuries are rare, the number of "crush injuries" increased by 100 ER visits every year, with 1,707 ER visits reported in 2010.

"This data can be the tip of the iceberg, because there could be kids who are hurt whose parents don't bring them to the ER. So this could be an underestimation of how often this is going on," Breyer said.

Fortunately, it doesn't look like falling toilet seats lead to too much physical damage, but there may be some lingering mental trauma.

"The vast majority of these injuries were treated in the ER and then sent home… My sense is that it's just a very traumatic and unpleasant experience to go through, but it would be important to know that there is no damage that happens to the penis or patient," Breyer said.

WATCH THOSE WOODEN AND CERAMIC SEATS

While Breyer said there is no evidence to link the two, there have been reports that the sales of heavy wood and ceramic toilet seats are rising, which may account for an increasing number of visits.

"They may be more comfortable for people so the manufactures are making more of them and we are seeing more of these injuries," he said.

But parents of boys going through potty training may choose more male-friendly options, Breyer added.

For example, parents may want to invest in a U-shaped or "slow close" or "soft fall" models. Those, however, can be up to eight times more expensive than traditional lids.

"It's not a hard thing to change out," Breyer said.

SOURCE: http://bit.ly/13NOnhe BJU International, online June 14, 2013.

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