Do you know how to pee? (Two voiding tips)

The voiding world is strange. We’re all supposed to know how to pee, but surprisingly not all of us do it well. Let’s talk about the most frequent errors.

Don’t squeeze, don’t push

It is surely the most widespread error. Many, many people, especially women, push their urine out. They squeeze from the abdomen, as if the system needed that help to empty the bladder. And no, you don’t need it at all, what’s more, it can become a problem.

The strength of the micturition stream is undoubtedly important, as it helps protect against urinary tract infections. but the body It generates this force automatically, there is no need to push. The system is ready to urinate with power, you do not need help.

Peeing is an elaborate process, partly involuntary and partly voluntary.

The bladder is a bag closed below with two sphincters, one next to the other, one involuntary (automatic) and the other voluntary control. These sphincters open into the urethra, the tube that ultimately carries urine out. The bladder wall is made up of a muscle, the detrusor muscle. It is a muscle of involuntary contraction. When it contracts, it presses on the bladder and generates the force of the micturition stream

The kidneys are constantly generating urine, which is collected by the ureters and carried to the bladder, which accumulates it. The bladder gradually dilates and sends signals to the brain, reporting their stress levels, that is, the amount of urine they have. Little by little the signs become more insistent, until the person decides to go to the bathroom.

When it’s time to pee, the detrusor automatically contracts and the internal (involuntary) sphincter relaxes. At that moment the pee is only contained by the voluntary sphincter. So you just have to relax the sphincter, allow the urine to come out, not push it out.

What happens when we “help”?

By pushing we attack the pelvic floor in its weak point. The pelvic floor is the lower part of a balloon, a pressure system. The pressure increases have as their final destination the pelvic floor, which becomes weak and stressed. There are unavoidable pressures, but there are others that are easily avoidable. Pushing to pee is absolutely avoidable and totally unnecessary.

There may be circumstances in which there is not enough momentum, but there we enter the world of therapy. There may be weakness or difficulty in the voiding stream due to adhesions, detrusor malfunction, urethral obstruction, neurological problems… but even in these cases where the voiding system needs extra help, pushing is not a good idea.

The help should be pelvic floor physiotherapy. AND if you have to put pressure on the bladder to empty it, let it be with your fingers, directly on it, not especially the pelvic floor.

Do not cut the stream of urine

It’s another mistake. The “pee stop” is another widespread error, especially a few years ago. Currently much less, but in almost all the talks or workshops that I give someone comes out who still “pee stop”. This section is for them.

The “pee stop” is the act of peeing and cut the stream of urine to train the pelvic floor, that is, it is doing Kegel exercises by cutting the stream of pee.

This was highly recommended in the past, it was advised by the same doctors and health professionals, but now we know much more. We know that the “pipi stop” is not recommended, in fact, it can be a source of problems:

Urinary infections: The urethra, the tube that carries urine from the bladder to the outside, is a sterile tube. It is too easy for a drop that has already gone outside to be reabsorbed again when closing, when doing the kegel. If a droplet that has already left is reabsorbed, it will return full of pathogens, and that is buying numbers for the infection lottery. The exterior, no matter how clean it is, is not sterile.bladder dyssynergies. A dyssynergy is a malfunction. You have to know that urinating is a complex act. It requires a nervous system in good condition. Note that our children are incontinent until they are two years old, approximately, the time it takes for the nervous system to be mature enough for an act of this magnitude. At the other extreme, in people with some type of dementia, voiding retention is one of the first abilities to be lost.

The body has to synchronize and harmonize the sympathetic, parasympathetic and voluntary nervous systems. On the one hand, the detrusor is activated, compressing the bladder. On the other side and simultaneously, the involuntary sphincter relaxes. If when everything is ready and the three systems working together, we interrupt the process, to activate it again immediately afterwards, it is a stress and a possible source of problems.

Many kinds of problems can occur, but it is common for the automatic system to start giving errors, such as when the detrusor contracts to pee and the automatic sphincter closes instead of relaxing.

Watch yourself, how do you pee? Many people cannot imagine another way to urinate other than by squeezing. If this happens to you, let yourself help. It’s time for pelvic floor physiotherapy to help you, Time to re-educate the system.