Holding on for “just another hour” after your bladder feels full may seem harmless, but repeatedly ignoring the urge to go to the toilet could cause damage over time.
Regularly delaying trips to the toilet can overstretch the bladder muscle, making it weaker and less able to empty properly, according to Dr Sandra Elmer, a urologist and member of the Urological Society of Australia and New Zealand’s female urology leadership team.
“If you’ve overstretched it regularly, it can then become a bit weaker, so then when you do try and have a bladder contraction, it may not come out as quickly, or you may not empty your bladder well,” Elmer told 7NEWS.com.au.
Know the news with the 7NEWS app: Download today
She said occasionally holding on until it was convenient to use the toilet was normal and generally safe.
However, she warned people against regularly ignoring a strong urge for an hour or longer, as it could increase the risk of long-term problems.
“If you’ve got a strong desire to go to the toilet and you know you haven’t been in the last few hours, I wouldn’t be leaving it more than an hour,” she said.
Signs you may have held on for too long
The first sign many people notice is pain from a very full bladder, Elmer said.
She added that a noticeably slower stream after holding on for an extended period could occur because the bladder muscle had been overstretched and was temporarily unable to contract as effectively.
Other warning signs include a weaker urine stream, having to wait for the flow to begin, dribbling at the end of urination, or feeling as though the bladder has not fully emptied.
Some people may need to urinate a second or third time before feeling empty.
Poor bladder emptying can increase the risk of urinary tract infections and, in more severe cases, urinary incontinence.
“It can be very difficult to restore bladder function once the bladder muscle has been significantly damaged, which is why prevention and maintaining healthy bladder habits are so important,” Dr Elmer said.
“Unfortunately, there are currently no medications that can improve the bladder’s ability to contract.”
How often should you go to the toilet?
A healthy adult bladder can generally hold about 400 to 500 millilitres of urine, although bladder capacity and how frequently someone needs to go will vary.
Elmer said an adult drinking a typical amount of fluid — about 1.5 to two litres a day — would generally urinate four to five times over 24 hours.
That often equates to going about every four to five hours, although she said it was only a general guide and depended heavily on fluid intake.
People who drink more water, alcohol or caffeinated beverages are likely to need to urinate more often because they produce more urine.
The first sensation that the bladder is filling usually occurs at about 250ml, while a stronger urge to urinate develops closer to 400ml.
By about 500ml, most people will feel a strong urge or sense of fullness.
“By the time you’re feeling like your bladder is very full, you should be listening to your bladder and going to the toilet,” Elmer said.
Workers most at risk
People whose jobs make it difficult to access a toilet may be particularly vulnerable to developing unhealthy bladder habits.
Elmer said this could include truck drivers travelling long distances, as well as busy nurses, teachers and workers stuck in back-to-back meetings.
“Anyone in a busy, high-stress environment where they’re avoiding going, or just not having access to the toilet time-wise, can put it off because they aren’t giving themselves the time,” she said.
She also warned against restricting fluids to avoid using public or workplace toilets.
Regularly drinking too little can affect kidney health and increase the risk of urinary tract infections and constipation, she said.
Children should not be told to wait
Primary school children may be particularly vulnerable because their awareness of bladder sensation is still developing, Elmer said.
Unlike adults, some children may receive little warning before suddenly needing to use the toilet.
She said children should be allowed to go to the toilet as soon as they feel the urge.
“They should be given the opportunity to go when they need to, so it doesn’t set up bad bladder habits or anxiety about going to the toilet,” she said.
Being refused access could lead to accidents, embarrassment, anxiety around using toilets and even school avoidance, she added.
What about during pregnancy?
According to Elmer, needing to urinate more frequently during pregnancy is normal, particularly during the first and third trimesters.
Elmer said the uterus could reduce bladder capacity by taking up more space in the pelvis.
Some women may experience temporary relief during the second trimester as the uterus rises above the pelvic bones, before urinary frequency increases again as the baby grows.
Women who have recently given birth may also have reduced pelvic sensation and may not immediately realise they are failing to empty their bladder completely.
Is ‘breaking the seal’ real?
The common belief that urinating for the first time while drinking alcohol will make someone need to go repeatedly is largely a myth, Elmer said.
Alcohol is a diuretic, meaning it increases urine production.
Elmer said deliberately holding on to avoid “breaking the seal” could do more harm than simply using the toilet when needed.
“If you’ve been drinking alcohol and you’re making a lot of fluid, then you need to pee,” she said.
“It is dangerous to avoid breaking the seal when drinking alcohol.”
Anyone experiencing persistent difficulty urinating, frequent urinary tract infections, a weak stream, incontinence or a feeling that their bladder is not empty should speak to a GP.
