At larger marathons, theres usually a fair number of port-a-potties situated at the start, finish and various places along the course. At smaller races Ive done, theres usually some at the start and finish and sometimes a couple others along the course. If the number of port-a-potties is really lacking at a race, the race reviews often mention it.
Whether they are available or not, Ive often seen some guys just go off to the side and relieve themselves while facing a tree, building, etc. Women will more often wait in line or duck behind some object to do the same if no port-a-potty is available. As Ed mentioned, some runners just go as they run.
Of the 12 marathons Ive run, Ive had to use a port-a-potty once. My long training runs are usually 2-3 loops that take me past my house where I can grab a new water bottle and use the bathroom if needed.
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