Standing or sitting? How men should urinate for better health — a urologist explains

— Standing or sitting?

— A good question. But there is no single rule here.

It seems that urinating while standing is more physiological for men.

— But this has nothing to do with prostate hygiene?

— It's more related to the physiology and static of the pelvis. I believe we are more adapted to urinating while standing (this has evolved over the years). Animals also have different ways of urinating.

Many men urinate sitting primarily for reasons of hygiene and cleanliness, some elderly men find it easier to urinate sitting, while others find it harder.

There have been no precise studies on this. But it's an interesting point, perhaps worth doing.

— What else should men remember when urinating? I mean the mechanics.

— From early childhood, children should be taught certain habits. For example, from an early age, they should be gently taught not to interrupt the urine stream, not to squeeze the urethra for fun, because initially it's amusing, but then it turns out that an artificial obstruction of the bladder is created, and our entire urinary system is self-regulating and reacts to problems with certain mechanisms.

— In short, we don't play with our urination tool?

— We release urine naturally, preferably when we are relaxed. Some people have a problem that they cannot urinate in a public restroom or in front of a stranger. There are such conditions, they need to be treated. A colleague told me about a case where a patient developed alcoholism because he couldn't urinate in a public toilet, in front of other people.

— Here the problem is psychological, not physiological…

— Exactly. Because you have to remember that this is a very delicate and intimate matter. It's best to do it calmly, without rushing. And what is very important — in the most hygienic conditions possible. Hands should also be washed before, not only after. We are used to just washing hands after. But before — it's also worth it.

And also, if we notice that we have to strain our abdomen to urinate properly, then it's a signal that we should consult a therapist, or even better — a urologist.

— Returning to hygiene at the place of urination… It is often said that women are reluctant to use public toilets. Does this mean that men are safer? Do they contract infections less often?

— Intimate infections are unlikely to be related to public restrooms. They appear, rather, through sexual contact. It is not easy to contract syphilis or gonorrhea in a dirty restroom. This is an exaggeration. But it's always good to wash your hands so as not to spread bacteria to sensitive organs.

— And does a man have to urinate more often than a woman?

— Absolutely not. We should urinate the same number of times. There is no exact norm, but it should be up to 7-8 times a day. If more often, it already goes beyond regularity. But remember that this regularity is based on the Gaussian curve. It is individual. One person urinates once an hour all their life, another — twice a day. But these are extremes, they can be pathological.

Urinating seven to eight times a day is normal. Of course, with a night break. We should not urinate at night because then the kidneys produce much less urine. This is a mechanism that gives us from a few to eight hours of sleep. Waking up at night to go to the toilet is a sign that we have bad habits. Either you drink too much fluid or alcohol before night. Or some problems are starting, for example, with the prostate, or even worse, with the bladder itself.

— I asked about the difference in urination frequency half-jokingly, half-seriously. Because I meant a situation where a group of people of both sexes is walking, and the man has to occasionally go, say, into the bushes. And the woman will reach the destination. But, probably, this is only related to the ease of the process?

— I think so. Because at parties where there is a toilet, women go there just as often, especially in the company of friends. Both sexes should urinate equally often — every two hours or so. And the volume of this urine should be approximately 200 ml at a time, although there is no exact norm here. However, 50 ml is too little.

— Then another not-so-serious question. Does a human, or the human species, also feel the need to mark territory with urine?

— I don't know about that. I don't feel such a need (laughs). But it's a good question. I'll have to think about it.

— Let me explain more precisely. A person, say, needs to walk a few meters to the toilet, but closer to them is a tree or a bush, so they do it there…

— Maybe he thinks it's more hygienic there. But if not one person does it, but dozens or hundreds… We are a species that is too numerous in the world, and this creates various problems.

— And temperature matters (I'll still come back to that tree). Is it safe for a man to urinate in the cold?

— There is no proven link, but every urologist will say: dress warmer, especially if you have prostatitis. This may be because — I'm theorizing — hypothermia causes vasoconstriction in the pelvis, but that's just my theory. However, you won't catch a cold if you expose your penis to the cold.

— How should we dress in winter?

— Not too warm and not too cold — according to your feelings. You don't need to freeze or overheat what you have down there. You don't need to dress in a way that makes you sweat. Because there is also the issue of fertility here. For healthy sperm production, the testicles should not overheat. Underwear should not be too tight. It's not for nothing that nature placed the testicles outside our body, not kept them inside. They should be relatively free.

— Should one observe their urine?

— Absolutely. Any change in color should concern us. Odor — a little less, as it depends on the diet.

But any deviation from the norm should be investigated. Especially if blood appears in the urine. This is already an alarm signal.

Don't confuse blood with the color of beets; after beets, our urine also turns red. But blood can sometimes also be a sign of bladder cancer.

It is also worth paying attention to the specific gravity of urine. Because we often drink too little, and with a large body mass, stones form. Urine thickens, it has many substances that crystallize, and we form kidney stones. I always tell my patients, especially those with urolithiasis, that their urine should be clear, almost like water. Or straw-colored. It should not be concentrated, orange.

— What other color can urine be?

— The color of urine can also depend on the intake of various medications. Blue, green, brown, burgundy, light yellow. Various genetic diseases also affect the color of urine.

In general, the color should not be too dark, the odor should not be too unpleasant, urination should be natural, free. There should also be no burning sensation during urination. Burning or pain can indicate infection or pathology.

In women, the urethra is short and is a gateway for infection, while in men the canal is longer, and various types of urinary tract infections that manifest as pain or burning indicate pathologies. In this case, you should consult a doctor.

— Is urine transparency also important?

— In a way, yes, but it is also related to the consumption of certain foods or drinks. If we drink the right amount of fluid, the urine will not be cloudy. But if the urine, for example, foams too much — this could be a sign of protein loss or lipid problems. If you feel something abnormal — go to the doctor.

— Is urine pressure only related to the prostate gland?

— It is related, firstly, to bladder outlet obstruction. If the pressure is weak, it can indicate several problems. It can be an enlarged prostate, it can be defects and strictures of the urethra, but it can also be a problem with the detrusor muscle of the bladder, which contracts poorly. This can indicate various diseases; you need to consult a doctor.

Frequent urination in the absence of any symptoms may indicate an overactive bladder. This also requires treatment or verification of the cause. We must always rule out any neoplasms.

— Is there an optimal daily urine volume?

— It all depends on how much we drink. But consider that several hundred milliliters of fluid are released daily from the lungs, the same from feces, from sweat. It is recommended to drink 1.5-2 liters of water daily, which gives us 1-1.5 liters of urine.

— Perhaps the duration of a single urination is also important.

— Yes, because it indicates both the capacity of the bladder and a possible obstruction. If the bladder contracts, but the urine stream is narrow, this may indicate a problem with the prostate gland. It's good that women often think about these problems for us. We should praise them for sending men to a urologist.

— Because men themselves are afraid to go?…

— Of course, yes, although it is not a scary examination, there is nothing to be afraid of here.

Men over 40-50 years old should be periodically examined for prostate tumors — one of the most common types of cancer in their sex.

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