There’s a misconception that urine is sterile when it exits your body. It’s not.

Well I can say that since I've started drinking my own urine, I haven't been attacked by a bear.

If drinking my own pee is wrong then I don't want to be right.

I'll double check with my double board-certified MD wife, but last we talked about it, Yes, urine is sterile BEFORE it leaves the body. Obviously, the skin has many bacteria on it and anything leaving the body does too.

But the article goes further than if urine is sterile. It discusses if it is good for you. Well, generally, NO. Otherwise, we'd be plumbed differently – more like a desert pocket mouse.

Are there instances in which you SHOULD drink urine? Yeah, but they are a little contrived. If you'd be slamming down fresh water and pissing clear fluids, AND there were no water stops for 20 miles in the desert ahead, then you should piss in your water bottle and save it to drink later. But it would have been better (and far tastier) to have rationed your water a bit and carried it on your back instead of in your bladder.

That dude discovered in the Cypress Viaduct after the Loma Prieta Earthquake 25 years ago – Buck Helm ("Lucky Buck")? Who was trapped for 90 hours? My neighbor, a nurse, cared for him for the month afterwards. Perhaps if H.W. hadn't insisted on flying over – thereby interrupting rescue efforts, he might have survived, but since he died of of kidney failure 29 days later, I think we can take 90 hours as a limit (in those particular conditions of temperature and humidity) as a limit for survival without hydration, give or take presidential showboating.

So, going without water for 4 days or more? Drink all the piss you can (if you're not pinned under 240,000 pounds of ferro-concerete.)

Pissing dark yellow and water more than a day away? Do the sensible things (get in the shade midday, hike at night, don't mouth breath) and try to make it to less saline water.

The fuzzy area for me is if you are pissing highly concentrated urine and water is a day away (or an unknown time like the WWII life-raft survivors). Personally, I try to avoid those situation by swimming towards shore when the boat sinks and by not registering for the draft.

Ian and I were trapped in a life-raft once, panic set in and I can tell ya, Ian's urine is NOT sterile.

That was definitely my worst day in a public pool ever.

But what if you like the taste? Boil first?

I'm not sure we can pin Buck Helm's death entirely on lack of drinking water. Kidney failure from rhabdomyolysis is common after crushing injuries, often seen after bombings and earthquakes.

According to the LA Times: "He had injuries from head to foot, and was diagnosed as having a fractured skull, three broken ribs, bruised lungs, kidney failure and a broken ankle." Given the MOI, we can safely assume crushing injuries, too.

— Rex

But another glass of water doesn't HURT if you have a broken ankle, right?

More seriously, sure, crush and kill a bunch of cells and your kidneys will need to filter more toxins from your blood. Which is to say you need more hydration to dilute those toxins and pass them through your kidneys.

Medical rule of thumb: produce an ounce of urine an hour or be better hydrated. I'll push a Nalgane bottle of water on you. My wife will stick an IV in your arm.

Hiking rule of thumb: if your urine is visibly colored, you need to drink more water.

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Hi Doug –

Well, in my former life as someone board-certified to perform and read bacterial cultures, including those in urine, CCMS (clean catch mid stream) urine of healthy adults (i.e., no UTI) would not grow out any bacteria in cultures. But reading the extract of the study that your article was based on, it seems they catheterized women and used enhanced culture techniques to find that there was some flora in the bladder of most of the women in the study. Certainly around the outside of the urethra there is plenty of normal skin type flora, which shows up on standard cultures when the CCMS protocol is not strictly followed, but presuming that they used good technique with the catheters, it would seem that what grew out on their cultures was actually bladder flora, contrary to what I would have thought. Unless their "enhanced techniques" just amplified small amounts of contaminating skin type flora caught by the catheter on the way in? I'd like to know more about exactly what was done; this is quite interesting!

David – who was the nurse you refer to? I worked at Highland when Buck Helm was brought in as a patient there.
(edit: oops, I just remembered that he was transferred out to Kaiser, so maybe that's where your neighbor worked)