How To Pee “Properly”: Correct Urination Techniques For Optimal Bladder Health

We learn how to pee as toddlers getting potty trained by our parents. As adults, urinating is pretty automatic. We do it multiple times throughout the day, and don’t think too much into it. It’s quick, in and out of the bathroom, we're done, and we move on with our day. But, the question is, are you peeing properly? And if not, how might this be impacting your pelvic floor? 

Here are a few factors to consider on your next trip to the bathroom.

Position:

First things first, we need to put our body into the proper position to pee properly. The goal is to be in a position that the pelvic floor muscles can relax and lengthen in so that urine can pass through the urethra without any resistance. This means SITTING on the toilet seat. I promise you won’t get any diseases. The only part of your anatomy that should be making contact with the toilet seat is the back of your thighs and buttocks. Given this, it is extremely unlikely for bacteria to be transferred from the surface of the toilet to your genitals and therefore infection is improbable. 

But why is it so important to sit? If we squat over a toilet seat, our pelvic floor muscles are not able to relax completely. Some of these muscles wrap around the urethra so activation will result in tightening and squeezing around the urethra where the urine is passing through to be excreted. Imagine a kink in a hose. If something is squeezing around the hose kinking it, we often get spraying off in multiple directions, and trapping of the water within. The same thing happens when we hover during urination. So if you are really worried about the cleanliness of the toilet seat, carry around some lysol wipes in your purse to wipe it down, just don’t hover!

Similarly, when sitting on the toilet we want our feet to be flat on the ground. If we are up on our toes, we are again getting unwanted activation through the pelvic floor muscles. If you are on the shorter side, try using a stool or squatty potty under your feet to allow your feet to relax down flat onto a supportive surface. 

Time:

How do we know when it’s time to go pee? Typically, our bladder sends a signal to the brain as it begins to stretch and fill with urine. As the bladder fills up more and more, the signal becomes more urgent and tells the brain to “start looking for a restroom.” Unfortunately, many of us are taught as children to go to the bathroom “just in case” (JIC) before leaving the house. And while this might be best practice for potty training a toddler, it is not best practice for us as adults. When we go pee JIC, it prevents us from achieving complete filling of the bladder. Over time, this makes the bladder less and less accustomed to stretching, and disrupts the normal signaling from the bladder to the brain. This can result in symptoms of increased urgency and frequency of urination. Try to avoid going to JIC before heading to the grocery store or going on a short walk, and only go when you have the urge. 

Helpful tip: An easy way to tell if you are allowing for complete filling of the bladder is counting your urine stream in “mississippi seconds.” It should be a minimum of 8 seconds to indicate the bladder adequately filled. 

The second consideration we want to keep in mind when peeing is taking our time. Now this can be easier said than done if you have children running in the bathroom with you or banging on the other side of the door. However, it is important to avoid straining or pushing the urine out forcefully. The detrusor muscle is the smooth muscle surrounding the bladder that contracts to initiate voiding, and it is an involuntary muscle. This means you cannot voluntarily push to make the detrusor contract any stronger. Likely when you are pushing or straining during urination, you are only activating those pesky pelvic floor muscles, and like we said it’s important to keep them quiet during emptying. 

Breath:

You may have caught on to a common theme here; relaxation of the pelvic floor muscles is important. So how can we help facilitate this? We can practice diaphragmatic breathing or “belly breathing.” As you are sitting on the toilet voiding, practice taking a few deep breaths inhaling the air all the way down into the belly and then exhaling. This breathing technique helps lengthen the pelvic floor muscles, allowing the urine to expel through the urethra optimally.

Overall, the habits formed at a young age often result in poor voiding practices that can lead to symptoms of increased urgency and frequency, incomplete emptying, and pelvic floor dysfunction. So next time you head to the bathroom to pee, think of the following steps:  

Step 1: Wait for an urge before heading to the bathroom (NO “just in case”).

Step 2: SIT on the toilet seat with feet flat on the floor, using a stool if needed.

Step 3: Take your time!

Step 4: Breathe into the belly to promote relaxation of the pelvic floor muscles. 

This blog post was written by pelvic health specialist: Dr. Alyssa Demeule, PT, DPT. Dr. Alyssa is currently accepting new patients.