To pee or not to pee? You know the problem ladies?
It’s a dilemma many of us face on a daily basis depending on the location of available pit stops between home and our destination.
Many of us choose to force ourselves to go to the loo at home as insurance before heading off and/or “take the opportunity” when passing a loo while out and about even though we don’t really need to go?
In other words do you plan ahead and force yourself to go because of a fear of being “caught short” later or do you hold off which can result in you bursting?
Or are you one of those who actually hold on too long even if a toilet is available.
It’s a problem because there are downsides to going too often and actually holding on too long.
While it’s OK for us to hold in our pee every now and then, medical advice is not to do it too often or it could lead to some serious problems down the road.
Gynaecologist Elizabeth Farrell, medical director at Jean Hailes for Women’s Health said it was “very important” to let your bladder function normally and to empty your bladder when your bladder tells you to.
“If you keep going ‘just in case’ too often, the bladder never fills up properly, then it shrinks a bit,” she said.
“So then you do tend to have the feeling that you’re going to have to go more frequently.”
Fortunately, most of us have full control over our bladder function, so when we receive this message, we can choose to either relieve ourselves right away, or hold it.
But what exactly are we doing to our body when we hold all that pee in?
A “normal, everyday person” should pee every four hours according to Urological Society of Australia and New Zealand spokesperson and University of Wollongong Associate Professor Peter Chin.
This equates to about six trips to the toilet in a 24-hour day, but if you’re still worried about the numbers there are other factors to consider, including how much you drink, what you drink, how much urine you produce and your bladder capacity.
Professor Chin said people passed around 400 millilitres of urine, but there were other factors such as the size of your bladder, what you drink, what your kidneys produce and how well you store that urine.
Melbourne Urology Group urologist Lih Ming Wong told The New Daily any more than eight times per day in a 24-hour period or more than every two hours was defined as “urinary frequency”.
However, Dr Wong said the number of times you go to the toilet and how bothered you are by frequency is a subjective experience.
“Some people go a lot and it doesn’t worry them, but if you have blood in the urine, burning or stinging with the urine or there are signs of incontinence, you should see a doctor and initiate further investigation to find underlying causes,” Dr Wong said.
Outside of prescription use and medical conditions, one of the most common causes of urinating more often is drinking tea, coffee, anything with caffeine and alcohol consumption.
Dr Wong said he had met a number of patients who couldn’t explain their frequent trips to the toilet, until they were asked about how much coffee or tea they were consuming.
He said sometimes the answer was “six cups of coffee per day”.
“Caffeine is a diuretic and increases your urine production,” the Melbourne-based urologist said. “What you drink matters and caffeine and alcohol can create a big variation of normal urination.”
There are medications, and surgical procedures to stretch the bladder, but many urologists recommend retraining the bladder.
Dr Wong said “bladder retraining” was a fancy word for teaching someone to hold on for longer, but recommended seeing a “coach” in the form of a pelvic floor physiotherapist or urologist.
“Retraining the bladder is complicated and we usually do this for people who go to the toilet a lot, but can’t find the underlying issue,” Dr Wong said.
Professor Chin said many people often formed bad habits in childhood when told by a parent to go to the bathroom when it was convenient, rather than going when the bladder was full.
Professor Chin said while the average bladder could hold up to 400 mls, many felt the urge to go at 50, 100 or 150 mls.
“People will say they have a 10 cent bladder, but that’s because you’ve trained your bladder to go when you can actually hold a lot more.”
It’s okay to hold on occasionally when on a bus trip, or until the end of the movie, but It can be damaging if done on a regular basis.
Dr Wong said truck drivers and nurses were among the culprits holding “on and on”,running the risk of stretching the bladder and eventually losing muscle elasticity.
“If you overstretch your bladder it can stop emptying properly and a volume of urine is left behind,” Dr Wong said.
“If this goes on for a long period of time, you risk having a lot of urine being left in your bladder, increasing the risk of urinary tract infection, bladder stones and putting pressure on the kidneys.”
The actual physical result of being too busy to pee right now is that the cylindrical sphincters in your bladder close up tightly to keep all of the urine from leaking through your urethra.
These little muscles are great at what they do, until you make them do it consistently for a really long time.
If you make a habit of holding in your pee for ages, you’re subjecting yourself to pretty serious long-term effects, including a higher risk of infection.
Women who have recently given birth should avoid weeing when they don’t need to so they can retrain their bladders and pelvic floor muscles, which may have been stretched during childbirth.
But women should make a beeline for the loo after sex, even if they don’t feel the need to, she says, as this reduces the risk of urinary tract infections (UTIs).
“That’s not going ‘just in case’,” says Dr Farrell .
“It actually has a purpose: to empty the bladder so any bacteria around the urethral entrance or in the urethra might be shed when you have a wee.”
While incontinence is more common in women, the Continence Foundation of Australia reports around 20 per cent of people with incontinence are men.
It usually affects older men with an enlarged prostate gland or who have had prostate surgery.
It may not be something you think about every day, but maintaining a healthy bladder is important at any age, and especially if you want to avoid problems as you get older.
HOW TO HELP KEEP YOUR BLADDER HEALTHY
The Continence Foundation says there are measures you can take to keep your bladder healthy, including:
- Drinking enough water to ensure your urine is a light straw colour. The amount will vary depending on your exercise level and the climate, but aim to drink enough to satisfy your thirst
- Avoiding drinking too many caffeinated drinks such as tea, coffee, hot chocolate and soft drinks, as these can irritate the bladder;
- Performing pelvic floor exercises regularly, even if you don’t have incontinence.
By Steph Giancomo
She Society is a site for the women of Australia to share our stories, our experiences, shared learnings and opportunities to connect.