Micturition syncope is the name given to passing out after urinating. It generally happens as a one-off phenomenon rather than an ongoing condition, and is much more common in men than women. It tends to happen at night and can be exacerbated by excessive alcohol.
“Micturition syncope happens due to the blood pressure dropping and heart rate slowing when passing urine,” explains Frank Chinegwundoh, consultant urological surgeon at Barts Health NHS Trust in London. “I don’t know why this happens.” While there are theories that it takes place as a result of the vagus nerve being stimulated by attempting to control one’s flow, medicine currently has no definitive answer as to why micturition syncope occurs.
Thirty-eight-year-old James is younger than most men who find themselves fainting at the toilet, and had never heard of the phenomenon before his own episode.
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It started like any other piss. I woke up in the middle of the night desperate for a pee, but lay there for a while trying to get back to sleep so I wouldn’t have to get out of bed. It didn’t work, because it never works, so I went to the toilet. I didn’t bother putting any clothes on — it was about 3 a.m. and everyone was soundly asleep.
I lived in an apartment with two friends that was so, so gross. It was a massive London house that had been converted into as many shitty apartments as it could be, and it completely sucked. The bathroom was tiny, like an airplane toilet, and incredibly poorly ventilated so everything in it was permanently dripping wet. There were pubes stuck to the walls and stuff. We all knew not to leave towels in there, because anything would absolutely go moldy in a day. Absolutely fucking god awful.
I walked in and had my pee, then turned to the sink to wash my hands and everything went weird. I got a ringing in my ears, my vision went blurry and I just kind of receded from consciousness. I felt like I was fading away, no longer present. I’ve passed out from drinking loads of times, but it wasn’t like that at all. It was this woozy, incredibly unwell feeling, like a dimmer switch was being slid on my brain.
“Oh,” I thought, “I suppose I’m dying.” It felt rather unfair, as I was the happiest I’d been for years thanks to a new relationship and the promise that brought of one day not living in a cesspool. But I didn’t have time to dwell on the injustice because my legs gave out and I collapsed. The tininess of the room proved to be useful, though, as I narrowly avoided hitting my head on the sink by hitting it on the wall first. As I slid to the floor everything went dark, and that was that.
I don’t know how long I was unconscious for. Probably not very long, but the floor in there was so disgusting that even a millisecond would have been excessive. I woke up wet, cold and naked, with a sore head and all kinds of floor nastiness stuck to my back and ass.
I went back to my room, wiped all the crap off myself with a towel and climbed back into bed next to my sleeping girlfriend, completely freaked out and terrified. I wondered if I’d had an aneurysm or a mild stroke or something, and had visions of being loaded into an MRI machine or having my skull sawed open for my brain to be probed.
I went to the doctor the next day, who sent me for a blood test, and the conclusion was that I’d had an incident of micturition syncope, something the doctor unhelpfully described as, “Just a thing that kind of happens sometimes.” I asked if it would happen again, and he pretty much shrugged. Rather than the cutting-edge medicine I was hoping for, the main thing I was told was, “If you’re doing a really big piss at night, consider sitting down for it.”
I was pretty underwhelmed at the time but now, a few years later, it seems like pretty sound advice.
I’m aware this sounds a bit dramatic, but that uncharacteristically dramatic piss changed the course of my life. It’s not like some Sliding Doors or Back to the Future II Grays Sports Almanac thing where I’d be a Bond villain or drug smuggler if that hadn’t happened or anything, but it made me put things into perspective. The thing that scared me wasn’t so much the idea of dropping dead, it was the idea of dropping dead in the worst bathroom in England in a bunch of nasty piss and pubes. I was like, “Fuck this, if I’m dropping dead, I’m doing it somewhere nicer, and I’m seeing how this awesome girlfriend thing works out.”
So I moved in with my girlfriend, who was so kind to me when I was scared, and we’re married now and live in a house that isn’t actually the cleanest but at least all the pubes are ours. And if I wake up in the night bursting for a piss, half the time I’ll opt to sit down just in case.
I’ve sniped myself a few times — where I’ve sat down and accidentally sent a stream of piss between the seat and the rim into my lowered boxers — but that seems like a price worth paying to not worry about splitting my head open on the bathroom floor. I’d rather risk piss in my pants than piss in my brain.