Transcript of Should Men Sit When They Go To The Bathroom? | Mel Robbins Clips

I understand that you say that men should pee sitting down, Dr. Rina?

I don't think you have to pee sitting down. Where this came from was there was this study done where they interviewed 7,000 men around the country, around the world, and they found that German men sit more, and 40% of old German men sit to pee, whereas obviously in the US and other countries like UK and Australia, no one sits, right? And so then people are like, Oh, sitting is better. Sitting is better. So sitting when you're sitting, you can really relax your pelvic floor. So it will allow the urine to flow better. So what I tell women when they're struggling to pee is sit down, open up your legs wide, lean forward, and just relax and try to let the urine flow. Similarly, men can do those things to help urine flow through the pelvic floor. Now, if they have something like an enlarged prostate, or that's usually the most common cause of difficulty is urinating, they may actually have a better time or be more effective emptying their bladder sitting down. Down. Now, if they don't, it doesn't matter. Stand, sit, whatever you feel comfortable with. But sometimes people do find benefit for going twice.

If you feel like you're not emptying, what I tell women to do is sit, pee, relax, open your legs wide, really bend forward, and then stand up, walk around, sit back down and pee again. If you have a little bit of prolapse, even, sometimes that urine can shift and it'll help it come out. With men, I'll say the same thing. If you stand to pee, stand to pee, walk away, do a little walk, come back and try to pee a little more. Sometimes it'll get a little bit more out if you're struggling to... If you're having issues like you're maybe going a lot to the bathroom or you're having UTIs, you might have a little leftover there. And so when you come to the urologist, we actually scan your bladder. So after you pee, we'll put a little scanner on there to see how much urine is left so we can get a sense of what's actually going on.

So why do men have trouble peeing as they get older?

So the number one cause is the prostate. So the prostate is essentially this walnut-shaped organ that sits underneath the bladder, sits around the urethra or the pea tube, and it enlarges. If you think about it enlarges in almost everybody, 80% of 80-year-olds will have an enlarged prostate. It's very common. Let me give you an example. It's like when you're drinking from a straw. Say you go and get your bubble tea and you have a big wide straw, very easy. So that's a normal urethra. Think of that. Then say you get a coffee straw, those little tiny ones, and you try to drink through that. It's extremely hard.

That bubble will not go up into that straw.

So that's what's happening. As your prostate gets larger, that straw is getting thinner and thinner, and so it's more and more difficult to pee. And so that's usually why they have problems. And so we usually treat that prostate, whether it's with medication or with surgery if needed. And there's so many different options for surgery now. So you definitely see a urologist because there's so many options that we'd be here all day talking about it. But ultimately, there's tons of even minimally invasive options that can help.

And if that's happening, you should go talk to somebody. Absolutely.

I mean, it's a quality life thing. You go to the bathroom Every time you're struggling, can you imagine what that would be like?

Just standing there like, Come on, let's go.

It's very difficult, and especially a lot of them will wake up at night more often because they're not emptying as well, because that straw has gotten so narrow. And so they'll wake up at night to pee a lot. So their whole night is disrupted. It's really impactful for their quality of life.

So is it normal for a guy to have a little urine dribble out when they're done peeing?

Yeah, it's very, very common. So we call that post-void dribble. And it's actually a challenging problem. So sometimes it can be because of the prostate, right? So some urine gets stuck in the in the pea tube, and then it dribbles out after. Sometimes it can be because there's maybe a narrowing in the urethra, like a stricture that's more rare, like you've had some trauma or something, and there's a narrowing, and then that needs to be fixed. Sometimes it's because it's just the way your anatomy is, and some people always have a little dribble. So it's a little bit challenging, or the stream is so weak that it doesn't all come out. And so then there's like, you can maybe try to do some strengthening of the pelvic floor to help that urine come out.

Dr. Rina, what tools do you recommend for somebody who's listening to you going, I think I have an overactive bladder.

Yeah. So we talked about some. I think the avoiding bladder irritants, watching how much you drink. So I actually encourage people to take a diary. You can even Google OAB Diary, and you can find one like Urology Care Foundation has one. And you can write down what you're drinking, when you're peeing, how much you're peeing. And it'll give an idea, like what's going on. It can be diagnostics, you can take that to your doctor, but it can also be therapeutic. You're like, Oh, my God, of course I'm peeing a lot because I'm drinking all this, or I always pee very much after I have that coffee. That's one thing I think it's very helpful for a lot of people. I often joke, it's not homework. If you mess up, it's okay. Just do it and just figure it out. So that's one. If you're smoking, quit smoking. Smoking is a bladder irritant. So we talked about bladder irritant. Smoking is another one. Constipation, manage that. If you're overweight, so they found that when you reduce your body weight, if you're overweight and you reduce your body weight by about 8%, which is not a huge amount, depending on how much you weigh, it actually significantly improves your urinary issues.

So weight loss can be helpful for people who are overweight. Those are the things that we generally recommend for everybody. And they're easy and they're free and things you can figure out on your own. Now, if those don't work, then there's medication options and there's even surgical or third-line options that you can Botox your bladder, you can have acupuncture. What? Yeah, there's a whole bunch of things that we have in our arsenal that can help.

Does acupuncture help?

So it's called percutaneous tibial nerve stimulation. So it's based on acupuncture. It's a little acupuncture needle that goes into a nerve in your ankle that actually, if you follow that nerve all the way up, it goes to the nerve root of the bladder. You come to the doctor's office, we put that little acupuncture needle in, it's attached to a little device that sends a little electric stimulation there. And so it stimulates that nerve, and it restores normal nerve function. And so you go to the doctor's office 30 minutes once a week for 12 weeks. And if it works, you'll see by about the sixth week, and then every month after that. And so it's time consuming. I tell people there's very little risk, except for you might get in a car accident on your way to the doctor's office, but it's pretty safe. And then, yeah, you can Botox your bladder, too. So if you inject Botox into the wall of the bladder, it can actually relax the wall of the bladder so that you have less urgency, less frequency. Now, there's obviously risks with all these things, but this one has a little bit of risk of not being able to pee afterwards.

Can we just talk a little bit about pooping? Yeah. Like, what's normal? What should cause alarm? What should you be looking for? Should you be looking? What do you want us to know, doctor?

You should always look, right? You should look at your urine, look at your poop, right?

What am I looking for when I look at my urine? Because I used to be obsessed. This may sound like a weird little thing, but I used to I'm really obsessed with having urine that was clear because I look and be like, Oh, I'm really hydrated. But now I take all of these supplements and I'm like, Okay, that's expensive urine because that's bright yellow. But what should we be looking for when we're looking at our urine? Let's start there.

So for urine, what I tell people is you don't need it to be clear. You don't need it to be dark yellow because dark yellow means that you're probably not drinking enough. If it's clear, you're probably over drinking a bit. And it's usually not an issue. What we've seen in marathon runners, for example, who do these really long distance run, they drink a ton. Some of them get sick and you check their blood and their sodium is actually low because they drink too much. And that's a rare occurrence, but you don't need to drink to clear. What I tell people is drink to lemonade yellow, right? Everyone knows what lemonade looks like. It should be about lemonade yellow. If it's darker than that, drink more. If it's lighter than that, you can stand to drink a little less. You want to make sure there's no blood in the urine. There are usually bubbles from the force of the stream, but if you're I'm starting to see really foamy urine, that could be a sign that there's a problem going on. So blood in the urine, foamy urine, those things. And then what I also tell people is if it's cloudy or stinky and you have no symptoms at all, you don't need to worry.

Just drink more water.

So, Dr. Rina, If the person listening to us were to really just focus on one takeaway that you think is the most important place to start, what would it be?

I think the one takeaway I would have for you is, one, if you are struggling, ask for help. Ask for help. Even bring it up to your primary care doctor. But don't get discouraged because a lot of people don't have the tools. They don't know what to do. That doesn't mean they're a bad doctor. They just don't treat it. And so you need to find someone who can help you with those things. There are plenty of really well qualified doctors all around the world who'd be happy to help you. And so please don't give up hope. Please make that appointment, talk to your doctor. And use some of the tips I gave you in this episode because it could change your life for the better.

And what are your parting words?

My parting words are, as I mentioned earlier, that you're worth it, and you deserve to take time for yourself to take care of your body. Invest in yourself so that you can invest in others like you want to.

Dr. Rina, I'm literally going to go to lay down on my floor and start doing in those pelvic floor exercises, even though I have a sling. In describing it the way that you did, I now understand why this is important, and that my bladder and the rectum and vagina, it all deserves to have that pelvic floor strength in place because I want to live a long and vibrant and healthy life. And taking care of that now and making it something that I care about will help me do that. What is the pelvic floor? You said this is a very important part of your anatomy that we don't talk about enough that has an impact on everything from normal urinary function, normal pooping, your orgasm, all of it. Is it like a hammock down there?