Holding Pee For Too Long Can Weaken Pelvic Floor Muscles And Increase Risk Of Bladder Problems
During a night of drinking after throwing back a few beers, we "break the seal," or follow our urge to pee. Once we open the floodgates, our bladder control weakens, as we run back and forth between the bar and the bathroom for the feel-good release. One too many bathroom breaks later, we try to hold in our pee, but science suggests this could significantly damage our bladder over time.
In TED-Ed's video, "Is it bad to hold your pee?" host Heba Shaheed explains that resisting the urge to urinate can weaken our pelvic floor muscles that work to keep our bladder sealed, until we're ready to go. The external urethral sphincter, one of the pelvic floor muscles, provides support to the urethra and bladder neck. This muscle, along with others, prevents bladder leakage that could otherwise occur from the pressure of coughing, sneezing, laughing, or jumping.
How Pee Travels Through The Body
Surrounding the bladder are several organs that make up the urinary system, including two kidneys, two ureters, two urethral sphincters, and a urethra. Urine trickles down from the kidney, funneling it down into the two muscular tubes known as the ureters. The ureters are responsible for carrying the urine downward into the bladder.
The detrusor muscle, the wall of tissue in the bladder, relaxes the bladder, allowing it to inflate like a balloon. Therefore, when the bladder gets full, the detrusor contracts, and the internal urethral sphincter automatically and involuntarily opens, leading to the release of urine.
Typically, we should urinate at least four to six times a day, but what happens when we have to force ourselves to cinch it in?
Holding In Your Pee
Once the urine enters the urethra, it stops short at the external urethral sphincter, similar to a tap. When we delay urine, we keep the sphincter closed; we voluntarily open the flood gates when we release it. Stretch receptors inside the layers of the detrusor muscles send signals along our nerves to the sacral region of the spinal cord, triggering a reflex signal to travel back to the bladder. This increases the bladder's pressure, so we know it's filling up, causing the internal urethral sphincter to open simultaneously, known as the micturition reflex.
The brain can tell if it's a good time to urinate by sending another signal to contract the external urethral sphincter. We get the urge to pee when there's about 150 to 200 milliliters inside the bladder; 400 to 500 milliliters will make us feel very uncomfortable. Although the bladder can keep stretching; above 1,000 milliliters it can burst.
In rare cases, the bladder can rupture painfully requiring surgery to fix it. However, under normal circumstances, the decision to pee stops the brain's signal to the external urethral sphincter, causing it to relax, and the bladder to empty.
The Verdict
Holding in pee for too long, forcing the urine out too fast, or urinating without proper physical support (i.e., squatting), can weaken or overwork the pelvic floor muscles overtime. This can lead to an overactive pelvic floor, bladder pain, urgency or urinary incontinence.
Frequent trips from the bar and bathroom after breaking the seal doesn't sound like a bad alternative after all.