Is it Bad for Your Bladder to “Hold It”?

It depends…are you an urgent pee-er, or do you have a lazy bladder?

Huffington Post UK

The problem: going to the bathroom at the first sign of bladder urge

If you are unable to suppress the urge to go to the bathroom, this, by definition, is urinary urgency. In some women, this manifests as the feeling that you have to run to the bathroom as soon as you feel the need to go. Other women will experience bladder leaks with these urges if they do not go in time, which is known as urinary urge incontinence. Often times, women with urinary urgency will go to the bathroom frequently to avoid bladder discomfort or leaking on themselves. Imagine having to take a trip to the bathroom every 15 minutes — the condition is very disrupting.

The problem: holding your urine all day

This is sometimes known as “lazy bladder” or “teacher’s bladder,” however I often see this in women with jobs where they ignore urges to pee for several hours. When I say several hours, I mean 6 hours or longer, sometimes only peeing once at the beginning of their workday, plus-or-minus during their break, and then at home after work. Over time, usually years or decades, this can cause bladder muscles to become weak. Along with excessive urine holding, many of these women have other unhealthy bathroom behaviors like hovering over the toilet to pee or bearing down while peeing. Normally, urination should be a passive event — relaxing your pelvic muscles on the toilet should help your brain get the signal to squeeze your bladder automatically. However, holding your pee for excessively long combined with not relaxing your pelvic floor while hovering or bearing down leads to problems down the road.

The solution: bladder training

Like other muscles, you can train the bladder. I liken this to potty-training, but for adults. The solution to urinary urgency and hypotonic bladder begins with self-awareness. If you see a specialist, they will often begin your treatment by giving you a bladder diary to understand your symptoms. Once you understand your symptoms, then you can begin to work toward increasing time between voids if you’re an urgent pee-er, or going to the bathroom more frequently if you have a lazy bladder. This handout from the International Urogynecological Association (IUGA) explains bladder training for urinary urgency. For women with hypotonic bladder or overflow incontinence, they may need to start going more frequently on a schedule, even if they do not have the urge to pee.

Bill Nye taught me everyone is a shade of brown. This is a forum for all females about all things female. Official blog for Dr. Aldene Zeno MD, urogynecologist.

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