Aging (for men) – what nobody told you: pee slippers

“The 100-year-old man set off in his pee-slippers (so called because men of an advanced age rarely pee farther than their shoes),”

― Jonas Jonasson, The 100-Year-Old Man Who Climbed Out the Window and Disappeared

Guys, as you get older your bladder power goes down. This has some consequences – you don’t pee very far and you don’t empty out fully after pissing, which leads to drippage in your underwear. You wake up (once, twice, three times) per night and go to the bathroom now. If you search up this kind of stuff, chances are you will have found overly serious conditions such as “Urinary Retention”, “Urinary Incontinence”, “Overflow Incontincence”, “Bladder Outlet Obstruction”, “Benign prostatic hyperplasia (BPH)”, “blood and or cloudy urine”, “Nocturia” and all kinds of other nasties. This is not about that. This is about some of the better tips I have found to handle this dripping life we have now found ourselves in.

TL;DR

You get old and your muscles get weaker, you can hold less and your piss tube gets blocked. You have to handle your pissing, so drink less before you travel or need to be somewhere, especially caffeinated drinks. Double void, lean forward and whistle to empty your bladder. Do pelvic floor muscles (kegels) for more control. After you piss, milk your piss tube (ureter) behind your balls quickly to empty the tube out. Put your legs up before sleeping and try to go to bed at the same time every night.

So what exactly happens to you as you get older?

As you age the whole system around your piss (the kidneys, bladder, ureter [=piss tube], prostrate) change naturally. The kidney becomes lighter and can’t filter as much blood. The arteries supplying blood to the kidneys narrow. For women the piss tube shortens (theirs is called the urethra) and becomes thinner, which increases the risk of being unable to piss, but for men this doesn’t change. The prostrate gland can grow though and can block your piss tube. All your life, your bladder muscles contract without you actually needing to pee, but these contractions are blocked by your spinal chord and brain controls. As you get older your system stops blocking these contractions, leading to more urine left in the bladder after you have taken a piss and you need to go more often. Not only that, but the muscles themselves weaken. The bladder wall itself becomes less elastic and so less able to hold much pee.

Further reading: Effects of Aging on the Urinary Tract – MSD Manual 2022 / Aging changes in the kidneys and bladder – Medline Plus (National Library of Medicine) 2022 / The Aging Bladder – National Library of Medicine, National Center for Biotechnology Information (2004)

Some actually useful tips for people who are just aging and not seriously ill

Medication use: Alter use of medications that could worsen urinary symptoms.

• Talk to your doctor or pharmacist about prescription or over-the-counter medications that may be contributing to your BPH symptoms. Antihistamines and decongestants can cause problems for some.
• If you use medications that could make you urinate more, don’t take them right before driving, traveling, attending an event, or going to bed.
• Don’t rely on ineffective dietary supplements. Saw palmetto and other herbal supplements have failed rigorous scientific testing so far.

Fluid restriction: Change how much fluid you drink — and when — to prevent bothersome bathroom visits.

• Don’t drink liquids before driving, traveling, or attending events where finding a bathroom quickly could be difficult.
• Avoid drinking caffeinated or alcoholic beverages after dinner or within two hours of your bedtime.

Bladder habits: Change the timing and manner in which you empty your bladder to reduce symptoms or make them less disruptive.

• Don’t hold it in; empty your bladder when you first get the urge.
• When you are out in public, go to the bathroom and try to urinate when you get the chance, even if you don’t feel a need right then.
• Take your time when urinating so you empty your bladder as much as possible.
• Double void: After each time you urinate, try again right away.
• On long airplane flights, avoid drinking alcohol, and try to urinate every 60 to 90 minutes.

Try these techniques to relieve common urinary symptoms without medication

• Timed voids. Urinate at least every three to four hours. Never hold the urine.
• Double void. Before leaving the restroom, try to empty your bladder a second time. Focuson relaxing the muscles of the pelvic floor. You may try running your hands under warm waterbefore your second void to trigger a relaxation response.
• Drink plenty of fluids. Fluids keep the urinary tract hydrated and clean.
• Have a bowel movement every day. The rectum is just behind the bladder. If it is a full, it can prevent the bladder from functioning properly. Increase your fruit, fiber, water and walkinguntil you have soft bowel movements and don’t have to strain. You may add over the counter medications like Senna (Sennakot, SennaGen), Colace (docusate) or Dulcolax (bisacodyl).
• Comfort and privacy are necessary to empty completely. Give yourself time to go.
• Leaning forward (and rocking) may promote urination.After you have finished passing urine, squeeze the pelvic floor to try to completely empty.
• The sound of water can promote the bladder muscle to contract, but care should be taken
• not to promote bladder muscle instability with overuse of this technique.
• Tapping over the bladder may assist in triggering a contraction in some people.
• Stroking or tickling the lower back may stimulate urination and has been reported to be helpful in some patients.
• Whistling provides a sustained outward breath with a gentle increase in pressure in the abdomen that may help with emptying your bladder.
• General relaxation techniques can help people who are tense and anxious about theircondition.

Techniques for Complete Bladder Emptying – Urology Group Virginia

Pelvic floor exercises

The pelvic floor consists of layers of muscles and ligaments that stretch like a hammock, from the
pubic bone at the front to the tip of the back bone, that help to support your bladder and bowel.
Pelvic floor exercises can be done in different positions:
• In a standing position, stand with your feet apart and tighten your pelvic floor muscles as if
you were trying to avoid breaking wind. If you look in a mirror you should see the base of your
penis move nearer to your abdomen and your testicles rise. Hold the contraction as strongly
as you can without holding your breath or tensing your buttocks. Perform this three times (as
strong as possible) in the morning, holding each for up to 10 seconds – and three times (as
strong as possible) in the evening, holding each for up to 10 seconds.
• In a sitting position, sit on a chair with your knees apart and tighten your pelvic floor muscles
as if you were trying to avoid breaking wind. Hold the contraction as strongly as you can
without holding your breath or tensing your buttocks. Perform this three times (as strong as
possible) in the morning, holding each for up to 10 seconds – and three times (as strong as
possible) in the evening, holding each for up to 10 seconds.
• In a lying position, lie on your back with your knees bent and your legs apart. Tighten your
pelvic floor muscles as if you were trying to avoid breaking wind and hold the contractions as
strongly as you can without holding your breath or tensing your buttocks. Perform this three
times (as strong as possible) in the morning, holding each for up to 10 seconds – and three
times (as strong as possible) in the evening, holding each for up to 10 seconds.
• While walking, tighten your pelvic floor muscles as you walk.
• After urinating and you have emptied your bladder, tighten your pelvic floor muscles as
strongly as you can to avoid an after dribble

Post micturition dribble exercise (dripping, drippage, dribbling after peeing)

• After passing urine, wait for a few seconds to allow the bladder to empty.
• Place your fingers behind the scrotum and apply gentle pressure to straighten out the urethra.
• Continue this whilst gently lifting and stroking to encourage the trapped urine to follow out.
• Before leaving the toilet, repeat the technique twice to ensure that the urethra is completely
empty.
This technique can easily be used at home. When in public toilets it can be done discreetly, with a
hand inside a trouser pocket.
It only takes a few seconds and will avoid the problem of stained trousers.
Pelvic floor exercises for men can also improve this problem as it improves the tone of your
muscles

Male pelvic floor exercises and post micturition dribble – NHS Western Isles 2022 (PDF)

Many men dribble urine shortly after they have finished using the toilet and the bladder feels empty. Even waiting a moment and shaking the penis before zipping up won’t stop it. The medical term for this is post-micturition dribbling. It’s common in older men because the muscles surrounding the urethra — the long tube in the penis that allows urine to pass out of the body — don’t squeeze as hard as they once did. This leaves a small pool of urine at a dip in the urethra behind the base of the penis. In less than a minute after finishing, this extra urine dribbles out.

Here’s a simple technique that should help. Right after your urine stream stops, “milk out” the last few drops of urine. Using the fingertips of one hand, begin about an inch behind your scrotum. Gently press upward. Keep applying this pressure as you move your fingers toward the base of the penis under the scrotum. Repeat once or twice. This should move the pooled urine into the penis. You can then shake out the last few drops. With practice, you should be able to do this quickly.

What can I do about urinary dribbling? – Men’s Health 2022

Kegel Exercises

Kegel exercises, also known as pelvic floor muscle exercises, are the easiest way for you to control urinary incontinence and stress incontinence, as they can be easily added to your daily routine.

To perform a Kegel exercise, you just need to squeeze your pelvic floor muscles. These are the same muscles you would use to stop the flow of urine.

Simply squeeze these muscles for 3 seconds and then relax. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD) suggests building up to 10-15 repetitions, 3 times a day. You can do these pelvic floor exercises while sitting or lying down.

Bladder Training

This is an effective way to overcome overactive bladder symptoms and gain more bladder control. The exercise trains your bladder to hold more urine before needing to empty it.

First, you need to determine your baseline. Make a diary of how often you need to go to the bathroom throughout the day. Then try to go to the bathroom less often, holding in the urine longer between visits. It may feel uncomfortable, but doing this will help you gain more bladder control.

Bladder Exercises — How to Strengthen Bladder Muscles – Urology of Greater Atlanta

How to stop pissing in the middle of the night

• Limit liquids before bedtime: Avoid drinking water or other beverages at night to reduce the need to wake up to urinate.
• Reduce caffeine and alcohol intake: Caffeine can trigger the bladder to become overactive and produce too much urine.Reduce your intake of caffeine and alcoholic beverages later in the afternoon and evening. 
• Talk to your doctor about when to take medications: Some medications, such as diuretics, can increase nighttime urination. Ask your doctor about the ideal time to take medications so they don’t interfere with your sleep.
• Strengthen your pelvic floor: Doctors recommend pelvic floor muscle exercises to help strengthen key muscles and control your urinary symptoms. 
• Elevate or compress your legs: Some research has shown that you can reduce fluid buildup that leads to urination by elevating your legs or using compression socks before bedtime.
• Practice good sleep hygiene: Healthy sleep hygiene can help you get better rest. Doctors recommend relaxing before bed, going to bed at the same time every night, and making sure your sleep environment is quiet, dark, and comfortable.

Frequent Urination at Night (Nocturia) – Sleep doctor 2023

Ok fellas, so hopefully we will stop dribbling into our pants a bit more. If you have any tips to improve on this guide then I look forward to hearing from you!

Next we will be looking at sleeping issues. This is a subject that seems to have some kind of taboo on it, but once you raise it, you realise that loads of people suffer from them.

Robin Edgar

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