Doctors say it’s fine to pee in the shower

By Jocelyn Solis-Moreira, CNN

(CNN) — Here’s a secret that’s not really a secret — many people pee in the shower. Maybe you’re one of those people who don’t care since it’s all going down the same drain, or perhaps you’re one of those who find it unhygienic.

When it comes to going number one in the shower, urologists find it generally safe for both men and women. “There’s no downside, and it is just convenient for some people,” said Dr. Karyn Eilber, a professor of urology at Cedars-Sinai in Los Angeles.

“It’s really personal preference that people don’t like to associate a place where you clean yourself in the shower to a place where you also do some elimination.”

Urinating in the shower is unlikely to create any health problems, according to urologists, and it’s not likely to clog up the drain. Still, there are certain scenarios in which using the shower as a makeshift toilet might not be a good idea.

The effect on pelvic floor muscles

A common argument against standing up and urinating for women is that the position does not allow pelvic floor muscles to relax, leading to forced straining and incomplete emptying of the bladder. However, Dr. David Shusterman, a urologist and chief physician at Modern Urologist in New York City, said this assertion is not true.

The two muscles controlling the urine flow from your bladder are called the urinary sphincters. One is at the base of the bladder and another near the pelvic floor. Shusterman said pelvic floor muscles do weaken when people try to force urine out. That’s because straining yourself to push tightens the sphincters and puts extra pressure on the pelvic muscles and bladder, making urine hard to release.

You can avoid this forced straining by peeing in the shower. “In a warm shower, it’s very easy for you just to relax the sphincter and let the urine come out,” he said. “Contrary to claims of urinating in the shower being unhealthy, I think it’s actually healthy.”

Urination and infections

Eilber said urine gets contaminated with bacteria when you have an infection, such as a urinary tract infection, or UTI. Still, she said people should not worry about catching an infection if someone with a UTI peed in a public shower since the shower water would wash the urine away. “I wouldn’t worry about getting an infection from someone urinating in public bathing areas as much as any mold or fungus you’re stepping in,” Eilber said.

The only caveat is if bacteria get trapped in the skin while peeing. Shusterman said men with foreskin have to pull back to pee safely, and if they do not retract it, urine can get trapped underneath the skin. Doing so creates an environment for fungus to grow, increasing the risk of fungal infections. Women need to spread their labia to avoid bacteria from contaminated urine getting trapped inside the vagina. A shower would be helpful to wash away urine residue, he noted.

Low risk of skin infection

Since showers wash urine away, Eilber said it is generally OK for urine to land on legs and feet. However, when contaminated urine lands on an open wound, there is a low chance of infection, she said.

Urine is food for bacteria and fungi, Shusterman said. When it lands on an open wound, it can make the wound hard to heal because bacteria now have nourishment to keep growing, increasing the risk of bacterial infections. He advised putting a wet dressing on the wound to keep it clean and dry.

The urge to go when hearing running water

If you’re constantly urinating in the shower, Shusterman said there’s a risk of developing a psychological association between the sound of running water and the urge to pee. Since the two events happen together, the brain becomes conditioned to relax the bladder and the sphincter when it hears the noise, allowing urine to leak out.

Eilber said this link is not much of a problem for most people, as they just find it convenient to urinate in the shower without a second thought. However, for people who already have an overactive bladder, she noted that the noise can trigger involuntary urine loss. People with overactive bladders will have that urge to go when hearing running water from a sink, toilet or shower.

If you want to eliminate this link, Eilber recommended getting in the habit of emptying the bladder before you turn the shower on so there is no leakage. For people who get the urge to pee when hearing water but have trouble urinating, Shusterman advised seeing a doctor to get evaluated for urinary incontinence. A urologist can give treatments targeted to relax the bladder and strengthen pelvic muscles.

Avoid urination in baths and hot tubs

Peeing in the shower may not be bad, but that’s not the case for baths and hot tubs. Shusterman said warm, stagnant water is a breeding ground for bacteria and fungi. It raises the risk of bacteria entering your urethra when sitting in the tub.

Urinating in the bath worsens bacterial growth since bacteria have more resources to thrive. “Urine is a waste product for us, but for bacteria and fungi, it’s food,” Shusterman added. He recommended peeing after a bath to avoid infection risk and flush out any bacterial water that makes its way up the bladder.

All in all, where you decide to answer nature’s call is less important than when you do it. Shusterman said people should always strive to pee with a full bladder — between 400 and 600 milliliters of urine. So, don’t hold it in if you need to relieve yourself while washing your hair. Save a minute and chalk it up to productive multitasking.

Jocelyn Solis-Moreira is a New York-based freelance health and science journalist.

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