Should Men Sit or Stand to Pee for Urinary Tract + Prostate Health?

In This Article

Do Real Men Stand or Sit to Pee?

Recently, I was having breakfast with a brilliant Ayurvedic practitioner and friend, Kashaypa Fisher, and somehow we got on the subject of whether it is healthier for men to pee standing or sitting—typical Ayurvedic breakfast conversation!

Kashaypa’s Ayurvedic teacher blamed many prostate issues men have today on the fact that they urinate standing, as opposed to squatting or at least sitting.

Then, a week or so later, my son came home from college and asked if it is “wussy” for a guy to sit while he pees. In his dorm, everyone stands to pee (except him), and the toilets become disgusting. Complaining to his suitemates that the toilets are gross, they asked him why he sits to pee! He told them he grew up with two older sisters and a younger sister who would complain when the boys would miss the toilet or leave the seat up, so he learned to sit and pee.

After both these discussions, I was compelled to look into the ancient wisdom and modern science of the optimal body position during urination!

History of Urodynamics

Terms like urodynamics, maximum urinary flow rate, void time, and post-void residual volume have been well studied to determine the risk of LUTS (lower urinary tract symptoms). In English, this article is about whether it is better for men and women to sit, squat, or stand to urinate.

In a 1918 study of the tribal Arawaks of Brazil and British New Guinea, published in The American Journal of Anthropology, it was noted that both sexes squat to poo and pee, as well as eat.2

In the British Journal of Medicine,during the English invasion of India, army doctors proclaimed traditional squatting toilets inferior to the more sophisticated “throne”-style toilets.1 New science in the field of defecation and micturation suggests they were wrong.

To squat during urination was also written about in The Origins of Buddhist Monastic Code in China. When a monks urinated, “they would roll up their clothes, squat close to the toilet, and not spit, blow nose, or talk.”3 In Ayurvda, when the downward moving apana vata is engaged urination or defacation, it is important for the mind—the prana vata—to be still, otherwise inhibiting the complete downward efficiency of apana.

Our hunter-gatherer ancestors all squatted to pee and poo. When civilization marched on and toilets were invented, they mimicked how humans were evacuating for hundreds of thousands of years: squatting toilets.

Urination Position: The Science is In!

In a meta-analysis of over 11 studies performed between 1999-2012, 800 subjects from all over the world were evaluated to determine the benefits of sitting vs standing during urination.4

Both healthy men and men with LUTS (Lower Urinary Tract Symptoms), such as BPH (benign prostatic hypertrophy), were evaluated.

They found significantly lower post-void residual volume (urine left to stagnate in the bladder) in the sitting position compared to standing. The maximum urinary flow rate (health and volume of urinary stream) increased and total voiding time (how long it took to fully empty the bladder) decreased. The results for healthy men were similar in sitting and standing positions, which suggests men should adopt the practice of sitting, since urinary tract and prostate health issues are extremely common in men over 50.4

In another study, standing, sitting, and squatting flow urodynamics were measured in 61 men with LUTS. Squatting and standing demonstrated significantly greater urodynamics than sitting. The fact that these subjects were all used to squatting toilets may explain why sitting during urination was less efficient.5

While women generally sit for both urination and defection, studies on women have found that sitting, instead of the traditional squatting, may make you prone to urological, gynecological, and colorectal disorders.6

This news make come a little late as standing urinals for women are already in production.

For sure in a pinch, standing to pee for men and women should be made available so women do not have to navigate disgusting public bathrooms. For events check out the new LaPee, an open air standing women’s portable urinal.

Lapee: the first urinal for women to pee hygienically outdoors ...

Don’t Suppress the Urge to Urinate

Habitually and often unconsciously, we commonly find ourselves suppressing natural urges, thinking nothing of it. According to Vāgbhata (one of the most influential classical writers of Ayurveda), suppressing natural biological and emotional urges is a major no-no. There are 14 natural urges that we should not suppress, but typically do every day.7

For example, we have all learned how to hold our pee when stuck in a car or other situation where a bathroom is not to be found. When we think of life in the wild or in the animal kingdom, such suppression of natural urges would simply never happen.

Suppression of urination, flatus, and feces all cause downward-moving apana vata to stagnate and eventually move upwards, causing a host of digestive, urinary, and reproductive health concerns.

We recommend "14 Natural Urges We Shouldn't Suppress": https://lifespa.com/14-natural-urges-suppress/ 

Conclusion: How to Pee

Here are my peeing recommendations: Never suppress the urge to pee. If possible, sit or (better yet) squat to urinate. This will impact your urinary tract, reproductive, and prostate health, as well as maintain a cleaner bathroom.

Let us know how it goes!

References

  1. https://www.bmj.com/content/1/1174/1281.1
  2. https://books.google.com/books?id=kTsSAAAAYAAJ&pg=PA434&lpg=PA434&dq=anthropology+squat+urinate&source=bl&ots=Fb7gys4SNA&sig=ACfU3U3mxIfOVAlaIYMk4qYSmkDtTVFXdg&hl=en&sa=X&ved=2ahUKEwjFt5SJ9a7oAhUJZc0KHSP9C20Q6AEwCXoECAgQAQ#v=onepage&q=anthropology%20squat%20urinate&f=false
  3. https://books.google.com/books?id=91OPcSUTFQ0C&pg=PA206&lpg=PA206&dq=buddhism+sit+or+squat+urinate&source=bl&ots=-AhbCqryCS&sig=ACfU3U1FPpyV_muXt32W0CC_rPBWPF9Q0A&hl=en&sa=X&ved=2ahUKEwiHovG47a7oAhVDYs0KHWeyDZEQ6AEwDXoECAgQAQ#v=onepage&q=buddhism%20sit%20or%20squat%20urinate&f=false
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106761/#pone.0101320-Barnes1
  5. https://pubmed.ncbi.nlm.nih.gov/19634168/
  6. https://pubmed.ncbi.nlm.nih.gov/24346813/
  7. https://lifespa.com/14-natural-urges-suppress/

7 thoughts on “Should Men Sit or Stand to Pee for Urinary Tract + Prostate Health?”

  1. Great article, John!! Incredibly timely for men of my generation now in their 70’s whose urine flow has gone from strong to weaker. I was also raised in a culture to think that urinating sitting down was being a “wussy.” Well, from now on I’m going to embrace my wussiness! Thank you so much for writing this article.

    Reply
  2. I once bought a squatty-potty attachment for my toilet so I could assume a squatting position when on the toilet; I gave it up because it was too hard to pee into the toilet that way (as opposed to out over the front edge of the toilet), but I get the the ergonomics. So to make sitting and peeing even stranger, perhaps facing the back of the toilet would work better, but I think I’ll just squat a bit while standing and get some workout of my thighs at the same time!

    Reply
    • Just sit on your toilet and use a small object that you can put your feet on.
      Heightening your feet that way is physiologically very similar to a squatting position (shape of your sigmoid colon), but more comfortable than real squatting.

      Reply
  3. In Switzerland most men are sitting to pee after their ladies started to complain about the drops and puddles on the floor.

    Reply
  4. I have a “squatty potty” and I thought the idea was just to elevate the legs while sitting. Are you saying we aren’t actually supposed to sit but use the elevation to “squat” over the potty? Learning all the time..

    Reply
  5. One more positive to report. If nature calls in the middle of the night. I can make my way to the bathroom, get into position, sit and let it flow without turning on a light. Makes getting back to the bed and sleep much easier.

    Reply

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