Does the word “pee” fit the media? On this issue, opinions are decidedly divided. If you can talk elegantly about “micturition”, “urination”, then why the “pee” associated with pee? The main thing is to pee properly. By focusing on linguistic correctness, we will not reach those who may have a problem with this. A lot of people are looking for information about pee on the internet. Thus, with the help of experts, we will try in our cycle to dispel the most frequent doubts related to urine and its excretion from the body.

Dr. Hanna Szweda (in the photos in our gallery at the top of the article) is a urogynecologist. More specifically, he is a gynecologist who is particularly concerned with the broadly understood health and function of the pelvis - including problems associated with urination. The specialist promised to clarify issues that we do not talk about on a daily basis. Many people hesitate to talk about it even with a doctor. Doctors, meanwhile, rarely ask about these “shameful” problems. The result is that only a small percentage of patients with pelvic conditions receive adequate treatment. No sense, there is nothing to be ashamed of, and the treatment is simple and effective.

Pissing is not a challenge

How do I know if I pee properly?

If the patient does not see a problem with his urination, he is probably urinating correctly

- convinces Dr. Hanna Szweda and emphasizes that urinating is not some elaborate activity. You take off your panties. You sit down. You pee. You do not help yourself with a strange position or “squeezing” urine. You're not combining. You finish. You put on your panties and after the case. You don't have to make corrections or worry about something dripping there. By topic.

Peeing in the first place should not be burdensome, it does not require effort or special efforts.

Urination in numbers

How many times do we have to pee to be okay?

Modern medicine is no longer inclined to write indisputable recipes of a healthy lifestyle for everyone. It used to be that the norm of daily micturition was precisely defined. The normal frequency was considered to be urination up to 8 times during the day. Pissing at night was permissible once. And in fact: most often, except for exceptions, getting up to pee more than once is a cause for concern, referred to by doctors as nocturia. And what about the daily norm? Counting doesn't really make sense.

- I no longer ask patients how many times they urinate, only if they do it often. If in response I hear that the patient needs to use the toilet more often than her colleagues, in a new place she is immediately looking for her, needs to leave the cinema during the session and generally feels discomfort associated with the frequency of urination, it is possible that something is wrong. It doesn't matter if he says he pees six or 12 times. You have to start to be interested in it and diagnose,” says Dr. Schweda.

It is also important to note a clear change.. If we suddenly pee differently than before, and we do not find a rational explanation for it (such as consuming a large amount of fluids, taking diuretic drugs), it may be a signal that some change has occurred and may be a signal of illness.

From the very number of mictions, a more objective indicator is the capacity of the bladder. The correct one is in the range of 350-650 ml. This can be preliminarily checked on your own, for example, by keeping a so-called “micturition diary” - record for 2-3 days the amount of fluid taken and the volume of urine excreted. A more accurate assessment is possible during a routine ultrasound examination. It is also possible to detect a possible backlog of urine, which would indicate improper emptying bladder.

It's not true that you need to pee to zero, to completely empty the bladder. Up to 100 ml of urine can remain in it, and it does not bother at all. Sometimes, in the elderly, even a little more. And yet there is such a belief that you need to completely empty the bladder, to the last drop.

- I observe this many times during Urodynamic examination. It requires sitting on a special toilet. It allows you to assess the functions of the pelvic floor, urethra and bladder, as well as the correctness of the accumulation of urine and its excretion - the coordination of all these elements. Many patients try to forcibly empty the bladder to the end. It is urinated piece by piece, intermittently. I ask if it usually looks like that, and I hear it doesn't. “This is for research purposes,” says Dr. Schweda. However, he emphasizes that the reference point is always how much urine was in the bladder at the beginning. If there was about 700 ml in the bladder and 150 ml remained after emptying, then most likely everything is fine. However, when before peeing there was only 250 ml, and after it still remains 100 ml, it is worth looking into the matter. Especially when the patient reports other problems. It should be remembered that general norms are indicative, and each person and his health situation should be approached individually by a doctor.

Pissing - how do I know I have a problem?

Self-diagnosis of urinary retention is not too complicated - you just need to closely monitor your body.

An important signal is a clear disproportion between the severity of pressure on the bladder and how much urine has actually flowed out. If you really wanted to pee, your belly was bloated like a balloon, and then suddenly two spoons flew out, something is wrong.

Also disturbing is the situation when you simply have the feeling that you are not urinating to the end, after micturition there is a constant feeling of pressing or pain.

What if you are convinced that you have urinated to the last drop, and in five minutes you fly to the toilet again? This also needs to be clarified with the doctor. As well as frequent urination. If the teacher claims that he rushes to pee at every break, he does not fit into the norm. It is possible that his bladder never empties to the end and is constantly full.

Recurrent infections can also be a warning signal. Residual urine is an ideal breeding ground for bacteria. Of course, urinary tract infections have many causes, however, it is worth excluding their possible source in an incorrectly working bladder. Neglect of such a problem threatens even permanent destruction of the kidneys.

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Causes of bad urination

Proper urination depends primarily on three key elements and the coordination between them. Effective cooperation must take place between:

1. Urinary bladder
2. Urethral
3. pelvic floor.

The bladder must stretch properly when it fills and tighten when we urinate. The coil and pelvic floor must maintain a constant tension so that nothing escapes unchecked. This tension must be further increased during exertion or coughing fits.

An important role in the system is played by the brain. All this will not work properly when the information pathways are damaged. When there is a signal that we want to pee, the bladder tightens the detrusor muscle, which allows it to empty, and the urethra and pelvic floor relax to open the way for urine.

Unfortunately, any of these elements can break down.

The disturbance of the information signals (“we pee”, “we do not pee”) can be responsible for very serious neurological problems: from stroke and tumor, through dementia problems (alzheimer's, parkinsonism) and ending with demyelinating diseases such as multiple sclerosis (MS).

The urination control center is located in the lumbosacral spine. Thus, serious injuries, but also degenerative changes within it, can be responsible for problems with urination. Most Poles complain about the spine. Of course, this does not mean that everyone already has degeneration, but very many of us do or trouble will arise in the near future - diseases of the spine are diseases of civilization.

It is worth knowing that the spinal center also manages stool donation and sexual functions. So, many times, along with incontinence and its backlog (the problem can occur together), constipation (or urgent urges, less often stool release) and lack of orgasm appear.

Sometimes incontinence and other problems with urination are the first symptoms of distant problems, such as diabetes, heart disease, prostatitis.

A common cause is the lowering of the organs: the bladder itself, but also the uterus and the back wall of the vagina along with the rectum, which can occur even after a difficult birth.

Fight for quality of life

The above clearly shows that the incorrect work of the bladder does not apply exclusively to people of advanced age. In the case of multiple sclerosis, the consequences of traffic accidents or childbirth, we are talking about young people whose quality of life is significantly reduced. The problem, unfortunately, is often downplayed.

Many people hear after injuries that they should rejoice because they are alive. If, after damage to the spine, they do not lose the ability to move independently, one speaks of outright happiness. In commercials, fulfilled, well-groomed women boast of diapers that smell and absorb urine great.

Urinary incontinence is sometimes seen as “such a beauty” for women, especially when the problem concerns young people. If in older generations - mom, grandmother - there were also such problems, then even the most annoying ailments are taken as the norm. Yes, genetics is not irrelevant, but that does not mean that you have to settle for many years of living in discomfort. The reason for the lack of control over the bladder can be banal, easy to remove, and nothing is done about it anyway.

- Estrogen deficiency, which can disrupt bladder functions and contribute to problems in the bedroom, if only due to vaginal dryness, often appears in perimenopausal women. However, it is also the cause of many ailments during lactation, because lactation is such a “small menopause” - temporary, but annoying. The solution to the problems is the administration of estrogens into the vagina. This treatment is safe. In the worst possible case, with really considerable doses, there is a risk of slightly reduced female milk production. However, the benefits are not negligible for the whole family: a better well-being of the woman, less risk of infection, satisfaction with motherhood and physical closeness with a partner, assures Dr. Szweda.

Of course, there are much more serious causes of bladder problems that affect very young women. It is estimated that up to one in five people are the first signs of MS. Multiple sclerosis today does not have to be a sentence. We have excellent drugs that allow you to maintain physical fitness, protect against social exclusion. Of course, there are still problems with access to them, in Poland there are different treatment regimens than abroad. The first problem, however, is delayed diagnosis. It is worth knowing that if we have a problem “with the bottom”, it is also worth checking what is happening “at the top”, that is, to perform at least a head resonance. Fortunately, more and more doctors understand this.

How to pee?

Bad habits can also lead to problems with urinary incontinence or its retention in the bladder. Since childhood, we harm ourselves by urinating on a reserve or holding urine. It is also a problem to consume too little fluid, which is supposed to protect us from frequent visits to the toilet. All this can lead to disruption of the functions of the entire system.

Recently, there has been a lot of talk about the technique of peeing itself. Many “experts” demonize “peeing on Małysz” (in a half-standing position). We opt for it when you need to use a not necessarily clean toilet in a public place. Dr. Szweda assures that although from the point of view of physiology the best would be squatting to pee, it is not a drama to assume another position, especially occasionally.

Whenever possible, we should pee without straining and combining. No special planting or sloping. In an ideal world, we sit on the toilet, relax and that's it.

However, the world will not collapse if at work, even twice a day, you pee half-standing. This is often a better idea than catching an infection. Of course, the board can be properly protected - disinfect, put on an overlay (this is not at all so simple and comfortable when the toilet is very dirty).