Pee If You Want to go Deeper

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While I’m usually blogging about triathlon, today I want to discuss one of my other hobbies, scuba diving. Diving in the UK usually requires diving in a dry suit (not always, but trust me, it’s a LOT more comfortable). One of the biggest concerns that many have is about how to deal with the bladder situation. My good friend Dave Allen and I, get approached often about diving with a pee valve. Dave is a dive instructor with Rec2Tec and we’ve co-authored this topic, you can head over here to see how the boys do it….

I’ve been scuba diving for over 25 years, mostly in wetsuits or semi-dry suits. Back in the 90s, my first introduction to a dry suit involved VERY cold water. In fact, it was an ice dive. Since then, I’ve dove in various places: cold water, dark water, deep dives…but chose locations that were a bit more tropical or avoided winter diving, using wetsuits or even a semi-dry suit. In a wetsuit, when you have to pee, the solution is easy… you just go. In a dry suit, not so much. Back in the 90’s there wasn’t a convenient solution for women using dry suits, except for holding it and dehydrating yourself in hopes you could complete a dive without peeing yourself.

For some years there were some solutions for men (a zip at the front of the dry suit) or even just an external catheter system. For women though, there had been a major gap in the market. It was in 2015 that I learned about the ability to install a P-valve for women. I turned my ‘never again’ approach into ‘okay, let’s try this!’

I just want to start off and say, I have a bladder the size of a walnut. More than that, I drink A LOT of water and I have had some surgeries on my girl parts, so I do not have a bladder made of steel (although, I envy people that do). Cold water accelerates that for me, so I have to pee even more.

On most recreational dives I’m okay without a pee valve (anything under and hour). I am, admittedly, usually the first person to head to the toilets (or head) when exiting the water. UK diving really requires a dry suit and in 2015, I went to the dive show and got fitted for my new dry suit and pee valve. I was soooo excited. But… I was not sure how to use it, or really anything about peeing in dry suit. I did a lot of research, had some ‘interesting’ trial and error moments, so I thought I share this with you in hopes that it helps not only educate you on how to use a p-valve, but also helps you decide which path to take.

Why the p-valve?

For those of you asking, what are my options for diving in a dry suit? Well… you can just hold it (again, if you have a bladder of steel), nappies/diapers, the p-valve, or just pee in the suit (which is gross and defeats the whole purpose of the dry suit, right?). I am personally not inclined to use a diaper, the thought of sitting in my own urine does not appeal to me. Also, they leak. Again, not appealing. I have done too many dives where I’m sprinting for the toilets post-dive (usually ripping a wrist seal), not being able to get out of my suit fast enough.

When I am diving in a dry suit I intake much less water than I normally would, this isn’t healthy as it can lead to DCI (decompression sickness, etc). Hydration is important when diving repetitive dives and I also have a bit of anxiety as well about having to pee on a dive. I don’t know about you, but when I have to pee, it really distracted me on my dives and getting into more technical diving, this was not ideal. I needed a solution that eased my mind and my bladder.

So…enter in the P-valve.

The P-valve (in theory) allows you to dive without a diaper, eliminates bladder discomfort by enabling a person to glue (yes, glue – we’ll come to that in a minute) an external catheter to their lady parts, hooked into a tube that exits out the dry suit leg using a one-way valve. It’s a pretty awesome invention, but it’s not quite as simple as ‘plug it in and go’.

Which p-valve/catheter system should I buy?

If you don’t have a P-valve installed in your dry suit, you can have one installed at any time by the manufacturer or a local professional. While in theory you can do it yourself, I highly recommend allowing an experienced professional to install the valve itself to avoid leaking. I personally had mine installed at the time of ordering my Hollis dry suit, they used a SI TECH one-way valve. At the time of writing this I have an O3 custom dry suit on order and they use their own custom valve. Regardless of the brand, get the one-way P-valve installed in your suit.

There are various options for external catheters for ladies on the market today. The one that I found that got the best reviews (and seemed the most logical for me) is the She-P system. The She-P system is made from silicone and each one is made by hand and of fantastic quality.

At the time of purchase the She-P Classic was the one recommended. I bought the whole kit for it, which includes medical grade adhesive, removal wipes and the tubing required to attach it to the P-valve in my dry suit. You can find the classic version here.

I would honestly consider the She-P version 3.0. This will be my next upgrade soon. I explain why down below.

Preparing for the She-P

This is the area that where I had the most questions (and also, where most people ask me how this whole thing works). This article can be a delicate subject (no pun intended!), so let’s talk about the configuration of the She-P itself:

The She-P needs to adhere from the perineum to the front of you, with the tube sticking out the front. Keep this in mind when reading the below in terms of which area to prep.

Whether you’re using the She-P Classic or She-P 3.0 the preparation for attachment is the same.

• Remove the hair from your lady parts. I recommend shaving, waxing or laser hair removal. Shaving can cause irritation, if that is the case, look into waxing or laser. You don’t want to irritate the skin as you’re about to put some glue onto it. How much hair to remove? Think Brazilian, you need to clear the hair from the perineum to the front of your pubic bone. You can attach the device with stubble, but it does not make for a pleasant removal experience, and could potentially cause a leak when in use.

• My advice, just go bald down there ladies…. I personally went with laser hair removal years ago and that’s paying off tenfold now.

• Make sure there are not any moisturizers or oil on your skin. Taking a shower on the morning when you’re going to attach the device is recommended. Use a non-oily soap to make sure the glue can adhere to your skin.

Attaching the She-P

The first time you attach She-P I recommend that you have someone witness attaching it, it provides a great amount of humor. It wasn’t my first time, but I was still experimenting with my device, and I was with my friend Sandi, she wanted to see how I did it in person. So, in the middle of the car park at Stoney Cove, we attempted to attach the catheter in the middle of December. Not only was it cold out, but we couldn’t stop laughing. Definitely ensure your first attempt is at home and test it in the shower.

To ready the device to be attached, I do honestly recommend a mirror setup below you to see where you are attaching it, else you’ll end up like me, thinking you glued your butthole (true story). Since there is glue involved, I would highly recommend a pair of gloves to keep your hands from getting glue on them.

• Make sure the device itself is clean, remember where you’re attaching it to.

• Get out the glue for the device. The She-P kit I purchased comes with Hollister medical spray glue or you can use Urobond. As I’m not coordinated enough to use the little brush with the Urobond, I highly recommend the Hollister spray. As you’ll be spraying the She-P, I recommend placing the catheter on something that can be discarded (paper towel, piece of paper or parchment paper), but be careful not to glue the device to anything.

• Apply TWO layers of glue to the She-P. Spray the first layer of glue onto the outer flaps, avoiding the reservoir. I like to keep the glue towards the outside of the flaps, avoiding the very inner area by the reservoir (remember, this is medical grade glue, you don’t want to glue your lips together – or anything else that is down there). I’ve highlighted in red the area I aim to spray with the glue.

• Apply your first layer of glue onto the device, allow to dry for a few minutes (this is a good time to go have a cup of coffee – because you can!). I have heard others doing the first layer the night before, just make sure you don’t knock the device, get fluff on it, or some other disaster before the morning – hence why I do mine in the morning.

• After about 10 minutes I apply the second layer of glue, allowing that to dry to just where if you touch the glue at the slightest, it’s almost thick and sticky. Now, you’re ready to adhere it to you. Note: you can use one layer of glue if you’re only doing one dive, but I don’t find it adheres well enough for me.

• This is the fun part… Stand over your mirror or bring a friend. Line up the reservoir under you, meaning, aligned under your urethra (if you don’t know where that is, it’s where the urine comes out), with the hose pointing forward and press on from the front over the lips, then onto the sides and pressing through to the perineum. I personally have cyclists’ thighs, so I make sure just to have my legs open a bit and ensure the catheter is glued to the sides of my undercarriage. Note: You want to avoid getting glue onto your thighs (as I have done) and get a pretty good seal.

• Press the catheter onto you, don’t squat or go for a run. Press the device on and keep some pressure on it. If I let go, I find the catheter drops a bit from the weight of it…don’t do that. The weight of the tube will pull it down, hold it up so the seal doesn’t break or pull the skin (yes, it’s uncomfortable). Ensure the seal is glued on, for myself I find the area by the perineum to be the most difficult. I then don some spandex shorts over top. For me personally, this applies some pressure to the device, holds the tube up and keeps everything in place.

• Once the device is in place, I HIGHLY suggest going for a test pee. The first time you do this, get in the tub or shower. Trust me. While standing, do a SLOW pee, like VERY VERY SLOW pee, remember, that little reservoir is catching the urine and going down the tube, which can be a bit of a bottleneck. If you’ve never peed standing up as a female, it’s a very novel experience. I giggled continuously, until I realized it was like a firehose and I peed everywhere. Learn to aim.

• Since I’ve used the She-P a few times now, I ensure I pee as much as possible before attaching the device. I then pee before my dive in the toilets or before boarding the boat. Finding the right position to pee standing up is difficult. As mentioned, I find the point of attachment to the perineum the point of leaking for me. Others have found the front to be an issue. When I’m using a toilet with the She-P attached I find I have to face the toilet when standing, bend at the waist and allow the urine to go down the tube. Think of an awkward squat but facing forwards, pushing the hose towards the toilet bowl. I have tried standing in various positions to pee, and that is what works for me. Since you’re not using the device much on dry land this shouldn’t be your focus, but I find a test pee a good way of checking for leaks.

• There are various ways to ensure the device gets some extra security in place. I personally, use a pair of tight spandex shorts. I also pull the front adapter up towards my belly button as that’s how I wear it in my suit (will explain that below). Many people have tried various ways to give the catheter extra security:
  • Two thongs – one over each leg, holding the She-P in place on the inner thigh. For me, this didn’t work, it was too restrictive, but go ahead and give it a shot.
  • Rubber/latex underwear – Some women swear by this. I searched for rubber/latex underwear, which brings up some interesting results on the internet. I did acquire a pair and when trying them, they were soooo uncomfortable and shifted a bit. I’ve tossed that idea out, but again, it may work for you.
  • Nappies/Diapers/sanitary pads – Some women will still wear a nappy/diaper to catch any drippage. I have a severe aversion to this…I’d risk the leak. You can also use a good sanitary pad in your underwear, probably the better option.
  • Waterproof medical tape – put this in your kit bag. If you find a leak on your trial pee, you can add some tape over the leaking area (see, this is why you want to get rid of all of your hair).

I hate to say it, but this is all going to be trial and error. The best part is, you can pee while diving and avoid the discomfort. The downside is that you might not make any friends if they know you’ve accidentally peed yourself. Try this all out in the shower the first time, and maybe use the pads/diapers on the first few dives until you’re comfortable.

Diving with the She-P

Once I get the She-P catheter attached I’m ready to go diving…woohoo!

Above I mentioned that I wear a pair of tight shorts, I take the hose and point it up towards my belly button. The shorts hold it in place and keep everything fairly pressed against the skin. I have tried pointing the catheter in a more downwards position, but I caused a kink in the hose, which caused a little backflow, so just try out what works best for you. I find sitting down with the catheter attached is interesting… i.e., driving in a car, sitting on a bench – heck, even walking, I feel a bit like a cowboy. It’s okay, it’s normal and as the day goes on, you get more comfortable with it.

When I’m getting dressed to dive, I have my shorts on, then I wear (sometimes) a thermal layer that goes on as normal. On top of that I wear my under suit. I currently have a Fourth Element Arctic two-piece suit. If you’ve ever seen a mens under suit when using a P-valve, they have a hole cut for their hose down the leg. I cut along the front of my under suit and had some Velcro sewn either side of the crotch. This provides an easy way to attach my She-P to my P-valve.

When I get into my dry suit I take the tube from my p-valve, run it up through the Velcro hole in the front of my under suit, also running that straight up the front of me to the other end of the catheter. I have the quick connector system that came with my She-P kit, I can easily plug the two ends together and voila!

I am routing both tubes up towards my belly button, I create an ‘S’ or ‘C’ bend, in the tubes, without actually causing a kink, I use the shorts to hold the catheter in place and the tube routes down through my under suit. You will need to find the position of the tubing that works best for you. For me, I found that when I’m diving, this is absolute best position, it also means that pesky perineum area doesn’t leak.

I’m all plumbed in and ready to go!

For my specific P-valve, I find that I have to ensure it’s closed, or it leaks. Most valves don’t do that, but mine does (hopefully my new one won’t). Also, if you keep the valve closed, you can get a reverse pressure that you’ll feel in the chamber, so open and close the valve a bit to release that pressure (especially if you feel it when diving).

Peeing on the actual dive takes practice. I have devised a specific hand signal that I’ve used with various dive buddies to say, ‘I need to pee’. It usually creates a laugh, a bit of mask flooding, then they awkwardly stare at you when you’re trying to pee. Again, you’re going to need to practice peeing. Personally, I cannot be swimming and peeing. I have to stop kicking. I usually hang out on a wreck and do my thing, but I usually find a deco/safety stop is the best place. I mean, what else are you going to do? Like I mentioned before, I keep my valve closed. My buddy can see me reach for the valve to open it, so I don’t even need a hand signal…yeah, it’s about as subtle as a brick to the face…so they know… I’m peeing. They usually make faces at me and cause again, more laughter.

No matter where you choose to pee with your P-valve, PEE SLOWLY. The urine should exit down the tube and all is good. I would highly suggest having a pee before exiting the water (again, for me it’s on a deco stop). I stay plumbed in all day, I’m usually okay between dives, but if you find yourself on a long surface interval or stuck in your dry suit. Just go stand in a quiet corner, open your valve and pee standing up. All the boys do it!

Removing the She-P

When you’re done diving for the day, un-clasp your hose from the P-valve, FLUSH OUT your P-valve asap if you can. Use a bottle with a small nose to flush out the P-valve. I use Milton with water to flush down the tube to my suit (and don’t forget to open your valve on your leg). I then rinse thoroughly with water and blow into the end of the tube with my mouth to get the liquid out.

I use the cap that came with the kit and close off the hose on the catheter after I’ve taken off my suit for the day. If I have to travel home or somewhere in a car, I just leave my shorts on, and the catheter is still attached. I have removed the catheter in different ways, each with varying levels of success…

• Wait until you’re near a hot shower and gently peel (be careful to not rip the catheter) it off of you.

• Peel back the catheter from your body and remove from wherever you are. I tend to go with this method, but I’ve had interesting results. One time I peeled it off too fast, my skin felt raw for a couple of days, and I spent the evening with an ice pack on my raw skin. Usually, I just get residual glue.

• No matter how I remove the She-P I end of up with glue on it and myself. I use the wipes to get off the excess.

• Wash the She-P with warm water and soap, wash the device all over and ensure that you run the soap/water through the hose. Hang the device up to dry, I have a little hook that I hang it from (with the hose pointing down, allowing it to drip dry).

• If you’re diving for multiple days in a row, clean the device after each day (and yourself). Travel with whatever cleaning fluids that work and stick to those.

• I’ve never taken off my She-P during a day of diving, I leave it on all day, but I’ve heard of people taking it off between dives. I would only recommend that if your dives are fairly far apart and you’re on a liveaboard. If you can survive with it on all day, that might be the easier option (if you’re not doing any other activities for the day).

Diving while on your period

While I don’t want to go too deep on this topic, it will happen. Up until that last 2 years, I had been on birth control for 20 years, so if I had a trip coming up I could just skip my period using my birth control. Since then, I’ve opted to go off birth control (that’s a whole other story) and have had to face what to do with my period, diving and the P-valve. Firstly, it all depends on your flow, if you have a heavy period, a diaper/nappy might be best. Second, it depends on what you usually use on your period to deal with the flow. I personally, gave up tampons several years ago and dive with a menstrual cup. I made the change due to several factors: reusability, better for the environment, easier to manage, better for endurance sports (and diving). The only downside is that it pushes on my bladder when diving (just a bit, but it’s noticeable).

I tend to keep the menstrual cup in and attach my She-P as I normally would. I can leave the menstrual cup in for over 8 hours if needed, so this method works really really well for me. If your flow is really light, you could potentially get away with nothing at all, as the reservoir would catch it, you just want to make sure that it doesn’t ‘overload the system’.

Conclusion

Diving with a She-P is awesome and a total game changer!  I’ve tried to make this blog as comprehensive as possible to cover off my experience and others that have tried diving with a P-valve.  As with anything, it all comes down to personal preference and a bit of trial and error.

Don’t let your bladder keep you from diving. There are several Facebook groups out there aimed at this, as well as Scubaboard.

Good luck and dive deep my friends!