Whether it's in the middle of a movie, during an important meeting with your boss, or the moment you leave your doorstep, when you gotta go, you gotta go. And sometimes you just have to fight back. Yet in the battle of your willpower versus your bladder, is there really a winner?
“The bladder is very adaptable,“ says Alex Shteynshlyuger, M.D., a urologist at New York Urology Specialists. “It’s designed to hold a lot of urine, so holding [your pee] for a little bit isn’t going to cause any problems.”
First, some science: Organs are born doing what they do, whereas many muscles need a bit more training. The bladder is a hybrid of the two, called a "muscular sac," which makes sense. We aren’t born knowing how to control our bladder (see: diapers), but with teaching and practice, we get the hang of it, says James Ulchaker, M.D., a urologist at The Cleveland Clinic.
The bladder is made of muscular and elastic tissue, and the fuller the bladder, the more the elastic tissue stretches. When it’s finally time to let loose, the brain signals the inhibitory nerves that it’s fine to squeeze, emptying your bladder (and triggering an “aah,” if there was an especially long line).
How Long Is Too Long?
If holding it is an infrequent, once-every-good-movie type of thing, there’s no real risk, Shteynshlyuger says. The danger lies in making a habit: when you're keeping it in a few hours past when you feel you need to go, for years at a time—the "extreme sports" version of bladder holding, as he calls it. (Imagine the truck-driver lifestyle, which involves holding back for six hours every day for years.)
So what's the risk? In those long-term cases, the elastic tissue can become damaged and eventually replaced by scar tissue, Ulchaker says. And while not irreparable, that opens you up to further complications like urinary retention, kidney damage, and increased risk of urinary tract infections. But again, that’s only in extreme, repeated cases, not your average one-off long car ride.
Peeing anywhere between four and ten times a day is normal, but if you feel like you're practically living in the bathroom, there are a few things you can do. For one, try drinking less alcohol. It's a diuretic (meaning it makes you pee more than you take in), so even if you go right before leaving the bar, it can still come back to haunt you.
Likewise, avoid the sound of rushing water. No one knows for sure why it has such a triggering effect, Ulchaker says, but Shteynshlyuger says it probably has something to do with a reflex between your brain, spinal chord, and bladder—a "hear the sound, do the thing" kind of situation.
One final tip: Nix the coffee or soft drinks before a long commute or suspenseful film. Caffeine affects certain receptors in the bladder wall, making your bladder contract more at lower volumes, Ulchaker says.
So it turns out there is a reason for the long line to use the Starbucks bathroom. It's not just the liquid that makes you have to go (like, now)—it’s the caffeine itself. Take it from Ulchaker: “If somebody comes to my office and says, 'I can’t pee,' I’ll give them a cup of coffee and they’ll pee. It may take a few minutes, but they’ll pee.“