Can hold it, hurt you?

DEAR DOCTOR:

This may seem like an odd question, but can “holding it” when you need to urinate damage your bladder? I sleep on the second floor of my house, but the only bathroom is on the first. Sometimes I just don’t feel like getting up! Am I hurting myself?

DEAR READER:

I’d say you’re in good company – we’ve all “held it” before, for whatever reason. Many of my patients ask me the same question you have. I’ve even had a patient ask if her bladder could actually explode from holding it too long.

The worst that’s likely to happen is that you’ll become increasingly uncomfortable until you finally give up and empty your bladder. The idea that your bladder can burst from waiting too long is largely a medical myth.

There are rare reports of bladder rupture in heavy alcohol users. Regular, heavy use of alcohol can injure the nerves that sense that a bladder is full and tell it to empty. And, of course, if a person gets really drunk, it can dull the brain: Those nerves from the bladder may be screaming that the bladder is full, but the brain is too dulled to hear it and do something about it. A full bladder is more easily injured than an empty one. Unsteady drunks can fall and injure their bladder.

The bladder is a mighty strong muscle. It is unlikely to rupture just because you hit the snooze button a few extra times. It’s much more likely that the urge to go will eventually just take over, and you will urinate whether you want to or not.

But there are potential health consequences of making “holding it” a habit. For example, research has found that women who regularly hold off on urinating when they feel the urge may get more urinary tract infections (UTIs). Sometimes bacteria get into the bladder. Urinating often eliminates the bacteria. But holding them in the bladder allows them to multiply. They multiply really fast: One bacterium can become millions of bacteria over several hours. So if you are prone to UTIs, urinate as soon as you get the urge.

Bladder problems are common. Because such problems can be embarrassing to talk about, a lot of patients don’t tell their doctors about them.

If I were your doctor, I would say this: Go when you get the urge, and go even if you don’t feel the urge but are about to be unable to go easily (like on a long car trip). If you feel the urge but it’s inconvenient to go, don’t worry that your bladder will burst.

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