Our Greatest Wealth Is Health

Andrew Siegel MD  8/15/2020

REQUIREMENTS FOR “LASER-LIKE” PRECISION OF YOUR URINARY STREAM^***

1. Bladder that contracts normally
2. Penis visible and accessible
3. Urethra (channel leading out from bladder) of normal caliber with opening on tip of penis
4. Sufficient urine volume in bladder to optimize bladder contraction (Starling curve)

_{***Even when all four criteria met, system failure often occurs!}

“Show me an aimer who never misses the toilet and I’ll show you a liar.”

–Anonymous (but certainly a woman)

“The truth of the matter is that many men have spray patterns that are highly variable and can mimic the patterns of a garden hose nozzle: cone, jet, angled, shower, full, flat, mist and soaker!” 

–Yours truly

Spinning urinal insert in bathroom of restaurant in LBI  to keep men “on target” and amused; It was my “lucky” day!

THE PHYSICS OF PEEING: FLUID DYNAMICS

When one stands to pee, his stream travels roughly five times the distance to the water or to the porcelain surface of the toilet as opposed to sitting.  Acceleration = 9.8 Meter/Second², so theoretically the increased time it takes to strike the target gives the stream more time for the force of gravity to exert its effect and greater velocity when it strikes the target. This is simply the effect of gravity on a falling object. Another key  factor is that the increased travel distance gives the stream time to break up into droplets and hence more splashing, splattering and ricocheting, striking undesired targets.

THE GREAT APPEAL OF STANDING TO PEE

The possession of a penis endows men with the luxury of emptying their bladders with “laser-like” precision in the upright position. Being able to stand to urinate and direct one’s urinary stream in an accurate trajectory is a distinct advantage over the clumsy apparatus of the fairer sex that generates a spraying, poorly-directed stream that demands sitting on a toilet seat. Many women are quite envious of this capacity for such a directed urinary stream.  The benefit of being able to stand to urinate (and keep one’s body appropriately distanced from the horrors of many unpleasant public bathrooms) is priceless.  Another bonus of the male design is the easy capability (when necessary) of urinating outside. Possession of a penis enables us to duck behind a tree and easily and readily empty our bladder on a golf course or on the side of a highway when there is no bathroom available. Many find the outdoor experience (“alfresco voiding”) entertaining, enjoying the pleasant sounds and visuals of a forceful stream striking the target (often a tree) with finesse, creating rivulets and cascades to show for our efforts.  Even the indoor experience is appealing– the spectacle of  bubbles, the stream-like soothing white noise,  the power of control aiming at a target.

Thank you Pixabay, for image of Manneken Pis from Brussels

PLAY MISTY FOR ME

But alas, not all men possess laser-like precision, even though we think we might.  The best aimed streams are often imprecise, creating a fine mist of barely visible, aerosolized droplets that may accumulate on the toilet rim, toilet proper and the floor. And many streams are far less accurate (than merely imprecise), tangential sprays that can be messy and take quite a toll on the bathroom floor. Many a fellow with persistent failure to accurately strike the intended target ultimately succumbs to sitting to empty their bladder as does the fairer sex, the impetus for the positional change being the unrelenting ire and frustration of their spouse who is the one often burdened and hassled with bathroom cleanups.  “Happy wife, happy life!”  Clearly, more married men sit to pee than single men.

WHEN IT’S OKAY TO PURPOSELY PEE ON YOURSELF

This is not recommended, but in extreme heat peeing on yourself can cool you down.  This is the case with turkey vultures who have dark feathers that absorb heat and lack the cooling mechanism of sweat glands. To counter the summer heat, they purposely urinate on their own legs, using urine evaporation to cool themselves down in the process of “urohidrosis.”  Not recommended for humans!

10 REASONS MEN MIGHT SIT TO PEE, ASIDE FROM SPOUSAL PRESSURE

1. Big pannus Poor lifestyle habits wreak havoc on penile anatomy. The large pannus (“apron” of abdominal fat) that accompanies weight gain and obesity causes the penis to be “buried,” making finding and exposing the penis challenging. When voiding in the standing up position with a recessed and internalized penis, urine can drip down one’s legs, onto one’s feet, spray on the floor (and even at times towards or on the gentleman next to you at the urinal!).
2. Disuse atrophy  Like every other organ in the body, the penis needs to be used as nature intended.  If one goes too long without an erection, erectile tissues including collagen, smooth muscle, elastin, etc., may become compromised, resulting in penile shrinkage and the possibility of needing to sit to urinate as the penis recedes into the body.  Use it or lose it!
3. Anti-sex steroid treatment Androgen deprivation therapy suppresses testosterone and is commonly used as a treatment for prostate cancer. Because testosterone is an important hormone for maintaining the health and the anatomical integrity of the penis, the low testosterone levels resulting from chronic use can cause penile atrophy and shrinkage, sometimes to the extent that sitting to urinate is necessary.
4. Prostate enlargement  BPH (benign prostate obstruction) is a common occurrence in the aging male.  The enlarging prostate pinches the urethra shut such that the forceful and precise urinary stream of yesteryear gives way to a weak, narrow, spraying and dribbling-quality stream and, at times, the need to sit to empty.
5. Urethral abnormalities: stricture/hypospadias/urethrostomy  Urethral stricture is a narrowing that may occur anywhere within the urethra that can impede the flow of urine.  When it occurs at or near the tip of the penis, it can act as a “spigot” and cause an erratic, spraying, forked stream. Hypospadias is a congenital condition in which the opening of the urethra is on the underside of the penis instead of at the tip. The abnormal urethral opening and location lead to a poorly directed, spraying quality stream.  A urethrostomy is a rarely performed surgical procedure that creates an opening in the urethra in the perineum (a.k.a. taint—the region between scrotum and anus) that demands sitting to pee.
6. Under-active bladder This is a weak bladder that lacks the contractile force to generate sufficient bladder pressures to create a forceful stream and empty the bladder. The weak, dribbling quality, spraying stream will at times necessitate sitting to empty.
7. Immediately following bladder cancer treatment  BCG is a treatment for bladder cancer in which live, but weakened tuberculosis vaccine is instilled in the bladder, kept in for 2 hours and then urinated out.  It is always recommended to sit to urinate for the initial urination after such a treatment to avoid getting tuberculosis bacteria splattered around. (It is also recommended to place Clorox into the toilet after urinating.)
8. Falling issues Men with balance problems who have difficulty standing and are subject to falling down and men who become lightheaded when standing up are often better served by sitting to urinate.
9. After sex After ejaculation, urination may be erratic, a situation that may occur when the walls of the urethra temporarily become stuck to each other from dried, gummed seminal fluid that did not fully exit the urethra.
10. Cultural/Religious  The Islamic religion emphasizes personal modesty, purity and cleanliness. Urine—being a waste product—is considered unclean, so most men of Muslim faith sit to urinate when at home. This maintains cleanliness by minimizing sullying one’s body or clothes with urine and maintains modesty by keeping the penis unexposed. The exception to this is public restrooms that are often unclean, so in this circumstance many Islamic men stand to empty their bladders.

ADVANTAGES OF SITTING TO PEE

• Less mess, splatter, and splashback; cleaner, and more hygienic
• Happy wife, happy life!
• Less noise (important under circumstances when “broadcasting” is not favorable)
• No need to flip up toilet seat (again, happy wife!)
• May ease bladder emptying by accordion-like action of sitting, leaning forward and crunching body
• If need to defecate arises, transition is a breeze
• Can take a break, relax, read your favorite magazine, sit a spell

DISADVANTAGES OF SITTING TO PEE

• Skin contact with possibly unsanitary toilet seat
• Slower process
• One missies the show–“performance art” with the spectacle and sounds of the “fountain” and the entertainment of splashing around like Manneken Pis
• Some perceive sitting as emasculating

Personal note: My wife is quite the “clean freak,” e.g., shoes off when entering house, dog’s butt cleansed with baby wipes, etc., etc.  On the topic of urinating she stated: “I think standing up to pee is disgusting.  There should be a funnel that men stick their penis in that drains directly into the toilet.” I should also mention that I enjoy standing to pee, no matter how loathsome it might be according to my wife.

“The considerate and scientifically astute among the male species should be willing to admit that sitting is the logical choice.”                                                                                               –Randy Hurd

Wishing you the best of health,

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community. He is a urologist at New Jersey Urology, the largest urology practice in the United States. His latest book is: Prostate Cancer 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families. 

Video trailer for Prostate Cancer 20/20

Preview of Prostate Cancer 20/20

Andrew Siegel MD Amazon author page

Prostate Cancer 20/20 on Apple iBooks

PROSTATE CANCER 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families is now on sale at Audible, iTunes and Amazon as an audiobook read by the author (just over 6 hours). 

Dr. Siegel’s other books:

FINDING YOUR OWN FOUNTAIN OF YOUTH: The Essential Guide to Maximizing Health, Wellness, Fitness and Longevity

PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food

MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual, and Urinary Health

Video on THE KEGEL FIX 

Tags: Advantages of sitting to pee, Andrew Siegel MD, Sitting to pee, Why men sit to urinate

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